Obesity Management in the Primary Prevention of Hepatocellular Carcinoma.

Simple Summary: Hepatocellular carcinoma (HCC) is an increasingly prevalent and deadly disease driven in part by the rising obesity epidemic. Obesity causes HCC by initiating and progressing fatty liver disease. As such, weight reduction with the intention to treat fatty liver disease appears ideal for the primary prevention of HCC, but evidence is limited. This review covers recent advances in the treatment and management of obesity and fatty liver disease as it pertains to HCC risk and prevention. We conclude that combinatorial lifestyle, behavioral, medical, and surgical therapies that maximize whole body and liver fat reduction have the greatest potential to prevent HCC; however, prospective studies are required to demonstrate effectiveness. Hepatocellular carcinoma (HCC) is the most frequent primary hepatic malignancy and a leading cause of cancer-related death globally. HCC is associated with an indolent clinical presentation, resulting in frequent advanced stage diagnoses where surgical resection or transplant therapies are not an option and medical therapies are largely ineffective at improving survival. As such, there is a critical need to identify and enhance primary prevention strategies to mitigate HCC-related morbidity and mortality. Obesity is an independent risk factor for the onset and progression of HCC. Furthermore, obesity is a leading cause of nonalcoholic steatohepatitis (NASH), the fasting growing etiological factor of HCC. Herein, we review evolving clinical and mechanistic associations between obesity and hepatocarcinogenesis with an emphasis on the therapeutic efficacy of prevailing lifestyle/behavioral, medical, and surgical treatment strategies for weight reduction and NASH reversal. [ABSTRACT FROM AUTHOR]