Background: Liver transplantation has become an effective treatment option worldwide for a wide range of malignant and non-malignant liver diseases. In Mongolia, the high prevalence of single and co-infections with viral hepatitis is a major contributing factor to the development of liver cirrhosis and primary liver cancer. However, data on the indications, clinical characteristics, and outcomes of liver transplantation in the Mongolian population remain limited. Aim: To evaluate the indications and clinical characteristics of patients undergoing liver transplantation and to determine their survival outcomes. Materials and Methods: This single-center, retrospective cohort study included 238 patients who underwent liver transplantation at the National Cancer Center of Mongolia between 2018 and feb 2026. Patients were categorized into two groups according to the indication for transplantation: malignant and non-malignant liver diseases. Demographic and clinical characteristics were compared between the groups. Overall survival was estimated using the Kaplan–Meier method, and differences in survival were assessed using the log-rank test. A p-value <0.05 was considered statistically significant. Result: The mean age of the liver transplant recipients was 49.0 ± 8.4 years. Relatively older male patients were more likely to undergo liver transplantation for malignant liver diseases, whereas younger female patients predominated among those transplanted for non-malignant conditions (p=0.0001). No statistically significant difference in body mass index was observed between the groups (p>0.05). MELD and Child–Pugh (CPT) scores, reflecting the severity and prognosis of liver disease, differed significantly between the two groups. However, no statistically significant difference in survival was observed between the groups at 1-, 3-, or 5- years after liver transplantation (p=0.974). Conclusion Although age, sex, and liver disease severity as assessed by MELD and Child–Pugh scores differed significantly between patients undergoing liver transplantation for malignant and non-malignant indications, no statistically significant difference was observed in survival at 1-, 3-, or 5- years following liver transplantation.

Background: Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related mortality worldwide and in Mongolia. Alcohol-related liver disease (ALD) and metabolic dysfunction-associated steatohepatitis (MASH) are two major etiological factors contributing to the rising burden of HCC, each presenting distinct clinical and pathological characteristics. Aim: To compare the clinical, pathological, and survival characteristics of patients with ALD-related HCC and MASH-related HCC who underwent liver resection. Material and Methods: A retrospective cohort study was conducted using clinical and pathological data from 980 patients who underwent liver resection between 2010 and 2024. Among them, 191 were categorized into the ALD group and 789 into the MASH group. Clinical parameters, laboratory findings, tumor pathology (size, grade, fibrosis stage, vascular invasion), recurrence, and overall survival (OS) were analyzed. A simulated Kaplan–Meier survival curve was generated based on group-level survival estimates. Results: Patients with ALD were significantly younger and predominantly male compared with those in the MASH group (p=0.0014; p<0.0001). The MASH group demonstrated more aggressive pathological features, including larger tumors (>5 cm), poorer differentiation (G3–4), advanced T4 stage, and a higher rate of large-vessel invasion (all p<0.05). Despite these findings, the MASH group showed a longer mean overall survival (92.6 months) than the ALD group (82.0 months; p=0.0206). Conclusion Although MASH exhibits more aggressive pathological features compared with ALD, patients in the MASH group demonstrated better overall survival. These findings underscore the importance of incorporating etiological differences into the diagnostic, therapeutic, and postoperative management strategies for HCC.