Objective:

To investigate the relationship between metabolic comorbidities and the prognosis of Chinese patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

Approach:

• Study Design: A retrospective cohort study involving 164 patients with HBV-related HCC from eight hospitals affiliated with Sun Yat-sen University, conducted from 2011 to 2021.
• Patient Grouping: Patients were divided into two groups: the MC group (with metabolic comorbidities) and the NMC group (without metabolic comorbidities).
• Statistical Analysis: Propensity score matching (PSM) and multivariate Cox regression were used to analyze overall survival (OS).

Key Findings:

• Overall survival was significantly worse in the MC group compared to the NMC group before and after PSM.
• Type 2 diabetes mellitus (T2DM) was identified as an independent risk factor for overall survival.
• The presence of T2DM, hypertension, and low HDL levels were independent risk factors for intrahepatic multifocal lesions at diagnosis.
• The presence of all three metabolic comorbidities was associated with significantly worse overall survival (p=0.043).

Interpretation:

Metabolic comorbidities are associated with poor prognosis and progression of HBV-related HCC, with a cumulative adverse effect on survival as the number of comorbidities increases.

Limitations:

• The study is retrospective and may be subject to selection bias.
• The sample size may limit the generalizability of the findings.

Conclusion:

The presence of metabolic comorbidities negatively affects survival in patients with HBV-related HCC, indicating that metabolic burden may influence prognosis.