Observational studyNature medicine2025
Long-term liver outcomes after metabolic surgery in compensated cirrhosis due to metabolic dysfunction-associated steatohepatitis.
Observational study in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2026Guideline
- Review
- Liver fibrosis in metabolic dysfunction-associated steatotic liver disease: epidemiology, risk stratification and therapeutics.BMJ open gastroenterology · 2026Review
- Differential Impact of Metabolic Bariatric Surgery Versus Semaglutide on Adverse Hepatic and Extrahepatic Outcomes in Individuals With Metabolic Dysfunction-Associated Steatotic Liver Disease and Type 2 Diabetes.Diabetes, obesity & metabolism · 2026Article
- Lifespan approaches for the prevention and management of steatotic liver disease.Nature reviews. Gastroenterology & hepatology · 2026Review
- Therapeutic targets for metabolic dysfunction-associated steatohepatitis: a personalized approach to disease management.Nature reviews. Gastroenterology & hepatology · 2026Review
- Metabolic liver disease: A summary of major guidelines and identifying opportunities to improve future guidelines.Diabetes, obesity & metabolism · 2026Review
- Current Trends in the Epidemiology of Obesity and the Association Between Obesity and Metabolic Liver Disease (MASLD/MASH).Diabetes, obesity & metabolism · 2026Review
- Management of obesity in advanced chronic liver disease.JHEP reports : innovation in hepatology · 2026Review
- Providing holistic care for patients with metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis: Key aspects of clinical assessment and how to develop individualised care plans for surveillance and interventions.Diabetes, obesity & metabolism · 2026Review
- TASL practice guidance for the diagnosis and management of metabolic dysfunction-associated steatotic liver disease (MASLD).Hepatology forum · 2026Article
- Impact of metabolic and bariatric surgery on MASLD: histological resolution and metabolic outcomes in a retrospective cohort.BMC gastroenterology · 2025Article
- Metabolic surgery in metabolic dysfunction-associated steatohepatitis: emerging evidence and clinical promise.Hepatobiliary surgery and nutrition · 2025Article
- Austrian multisociety consensus on metabolic dysfunction-associated steatotic liver disease : Austrian Society of Gastroenterology and Hepatology (ÖGGH), Austrian Society of Diabetology (ÖDG), Austrian Society of Obesity (ÖAG).Wiener klinische Wochenschrift · 2025Article
- Metabolic Bariatric Surgery for the Treatment of Metabolic Dysfunction-Associated Steatohepatitis (MASH): A Scoping Review of Biomarker and Histology Changes.Obesity surgery · 2025Article
- INTERLEUKIN-6 AND INTERLEUKIN-10 AS BIOMARKERS OF HEPATOCELLULAR CARCINOMA PROGRESSION: A CROSS-SECTIONAL ANALYSIS OF NUTRITIONAL, CYTOKINE AND SURVIVAL PARAMETERS.Arquivos de gastroenterologia · 2025Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
No therapy has been shown to reduce the risk of major adverse liver outcomes (MALO) in patients with cirrhosis due to metabolic dysfunction-associated steatohepatitis (MASH). The Surgical Procedures Eliminate Compensated Cirrhosis In Advancing Long-term (SPECCIAL) observational study compared the effects of metabolic surgery and nonsurgical treatment in patients with obesity and compensated histologically proven MASH-related cirrhosis. Using a doubly robust estimation methodology to balance key baseline characteristics between groups, the time-to-incident MALO was compared between 62 patients (68% female) who underwent metabolic surgery and 106 nonsurgical controls (71% female), with a mean follow-up of 10.0 ± 4.5 years. The 15 year cumulative incidence of MALO was 20.9% (95% confidence interval (CI), 2.5-35.9%) in the surgical group compared with 46.4% (95% CI, 25.6-61.3%) in the nonsurgical group, with an adjusted hazard ratio of 0.28 (95% CI, 0.12-0.64), P = 0.003. The 15 year cumulative incidence of decompensated cirrhosis was 15.6% (95% CI, 0-31.3%) in the surgical group compared with 30.7% (95% CI, 12.9-44.8%) in the nonsurgical group, with an adjusted hazard ratio of 0.20 (95% CI, 0.06-0.68), P = 0.01. Among patients with compensated MASH-related cirrhosis and obesity, metabolic surgery, compared with nonsurgical management, was associated with a significantly lower risk of incident MALO. In the absence of approved medical therapies for compensated MASH-related cirrhosis, metabolic surgery may represent a safe and effective therapeutic option to influence the trajectory of cirrhosis.
Indexed as
Identifiers
39870816What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.