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SIR 2026

Scientific Session

Gastrointestinal Interventions

Session: IO - Liver Ablation

138 - Impact of Metabolic Syndrome and HDL on Survival in Hepatocellular Carcinoma Following Thermal Ablation

Monday, April 13, 2026
4:21 PM - 4:30 PM ET
Purpose: To evaluate the impact of metabolic syndrome (MetS) on local progression free survival (PFS), intrahepatic distant PFS, overall PFS, and overall survival (OS) in early-stage hepatocellular carcinoma (HCC) following thermal ablation (TA).

Materials and Methods: This single-center retrospective case control study included HCC patients within Milan criteria, treated at UCLA Medical Center’s transplant center from 2005 – 2022 who underwent TA for curative-intent or bridge to transplantation. Kaplan-Meier analysis was used to estimate survival outcomes and log rank test was used to compare outcomes between those with and without differences between those with and without MetS. Stepwise Cox regression was performed to identify independent predictors of survival, incorporating a range of metabolic, clinical, and tumor-related variables.

Results: Of 126 patients in the final study cohort, 65(52.6%) in the MetS subcohort had significantly reduced intrahepatic distant PFS (hazard ratio [HR] 1.93; 95% CI: 1.18- 3.18; p = 0.009) and overall PFS (HR 1.78; 95% CI: 1.15- 2.77; p = 0.01). Following adjustment, the association between MetS and intrahepatic distant PFS (HR 1.9; 95% CI: 1.09-3.56; p=0.03) remained significant. Stepwise Cox regression consistently identified elevated HDL as a significant predictor in adjusted models associated with improved overall PFS (HR 0.98; 95% CI: 0.96-0.99; p=0.01), local PFS(HR:0.97; 95% CI: 0.94-0.99, p=0.005), distant intrahepatic PFS (HR 0.96; 95%:CI: 0.94-0.99, p=0.001), and OS(HR 0.95; 95% CI: 0.91-0.98; p=0.002).

Conclusion: MetS was independently associated with higher recurrence of intrahepatic distant HCC lesions,. while higher HDL levels consistently predicted improved OS, overall PFS, local PFS, and distant PFS. These findings suggest that pharmacologic modulation of lipids may enhance post-TA outcomes in HCC. Future studies should explore the role of lipid-targeted interventions as adjunctive therapy in the peri-ablational setting.