■系统评价和比较非酒精性脂肪性肝病（NAFLD）患者肝切除术后肝细胞癌（HCC）的总体（OS）和无病（DFS）生存率与其他危险因素。
■与其他危险因素相比，在NAFLD的情况下，不同的临床和肿瘤特征与HCC相关。目前尚不清楚这些差异是否会影响根治性肝切除术后患者的生存率。
■使用多个数据库检索了1980年7月至2020年6月在英语文献中发表的随机对照试验和观察性研究。提取患者的基线特征以及OS和DFS的风险比（HR），并进行荟萃分析。
■共纳入15项回顾性队列研究，共7226例患者。其中,1412名患者（19.5%）患有NAFLD，5814名患者（80.4%）有其他危险因素（例如，病毒性乙型肝炎或丙型肝炎，酒精性肝硬化,或隐源性肝硬化)。总结统计显示，NAFLD患者的DFS（HR=0.81；95%CI：0.70-0.94；P=0.006）和OS（HR=0.78；95%CI：0.67-0.90；P=0.001）均优于对照组。亚组分析还表明，OS有利于NAFLD患者与病毒性乙型肝炎或丙型肝炎患者（HR=0.80;95％CI：0.67-0.96;P=0.017）或酒精性和隐源性肝硬化（HR=0.68;95％CI：0.47-1.0;P=0.05）。
■肝癌切除后，NAFLD患者的DFS和OS优于其他危险因素患者。亚组分析和荟萃回归表明，NAFLD患者的生存优势在2015年后发表的研究和来自亚洲中心的研究中更为明显。
UNASSIGNED: To systematically
review and compare the overall (OS) and disease-free (DFS) survival after hepatic resections for hepatocellular carcinoma (HCC) of patients with nonalcoholic fatty liver disease (NAFLD) versus other risk factors.
UNASSIGNED: Different clinical and tumor characteristics are associated with HCC in the setting of NAFLD in comparison to other risk factors. It is still unclear whether these differences impact patient survival after radical hepatectomies.
UNASSIGNED: Randomized controlled trials and observational studies published in the English literature between July 1980 and June 2020 were searched using multiple databases. Patients\' baseline characteristics and the hazard ratios (HRs) of the OS and DFS were extracted and meta-analyses were performed.
UNASSIGNED: Fifteen retrospective cohort studies with a total of 7226 patients were included. Among them, 1412 patients (19.5%) had NAFLD and 5814 (80.4%) had other risk factors (eg, viral hepatitis B or C, alcoholic cirrhosis, or cryptogenic cirrhosis). Summary statistics showed that patients with NAFLD had better DFS (HR = 0.81; 95% CI: 0.70-0.94; P = 0.006) and OS (HR = 0.78; 95% CI: 0.67-0.90; P = 0.001) than the control group. Subgroups analyses also indicated that the OS favored NAFLD patients versus patients with viral hepatitis B or C (HR = 0.80; 95% CI: 0.67-0.96; P = 0.017) or alcoholic and cryptogenic cirrhosis (HR = 0.68; 95% CI: 0.47-1.0; P = 0.05).
UNASSIGNED: After hepatic resections for HCC, NAFLD patients have better DFS and OS than patients with other risk factors. Subgroup analysis and meta-regression suggested that the survival advantage of NAFLD patients was more pronounced in studies published after 2015 and from Asian centers.
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