From mechanisms to management: Early detection and improved treatment of MASLD and its related hepatocellular carcinoma

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease and is estimated to affect over a billion people worldwide. MASLD patients may progress to more severe forms, including metabolic dysfunction-associated steatohepatitis (MASH) and hepatocellular carcinoma (HCC) with or without cirrhosis. Recent data demonstrated that HCC represents the fifth most common cancer and is the second leading cause of cancer-related death globally, and MASLD has been recognized as a rapidly emerging cause for this malignancy. Given that, diagnosis at the early stage and assessing the risks of progression to HCC are critically important for MASLD patients. However, the optimal screening strategies for patients with MASLD at risk of cancer are still under debate. Although various studies have shown potential for MASLD-related HCC (MASLD-HCC) treatment, the clinical therapeutics are still faced with huge challenges due to the complexity of the pathogenesis of the disease. Herein, we present an overview of the current advancements of early detection and risk evaluation for MASLD and MASLD-HCC patients, and the therapeutic approaches adopted in current clinical management.