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World Journal of Surgery

, Volume 37, Issue 6, pp 1379–1387 | Cite as

Prognosis and Predictors of Surgical Complications in Hepatocellular Carcinoma Patients With or Without Cirrhosis after Hepatectomy

  • Toru MizuguchiEmail author
  • Masaki Kawamoto
  • Makoto Meguro
  • Yukio Nakamura
  • Shigenori Ota
  • Thomas T. Hui
  • Koichi Hirata
Article

Abstract

Background

Although poor liver function is associated with a high morbidity rate and poor prognosis in hepatocellular carcinoma (HCC) patients, the exact effects of liver pathology on the surgical outcomes of HCC patients are poorly understood. The purpose of this study was to assess how the liver pathology of HCC patients affects their prognosis and complications rate after liver resection.

Methods

Between January 2006 and November 2010, 149 consecutive hepatocellular carcinoma patients, including 79 noncirrhosis patients and 70 cirrhosis patients, were enrolled in this study.

Results

Among the noncirrhotic patients, operative time, fresh frozen plasma (FFP) transfusion requirement, tumor size, and serum retinol binding protein (RBP) levels were significantly higher in the complications group than in the complications-free groups. On the other hand, in the cirrhotic patients the prothrombin time (PT) and indocyanine green retention value at 15 min (ICGR15) of the complications group were significantly lower and higher, respectively, than those of the complications-free group. In the noncirrhotic patients, recurrence-free survival and overall survival did not differ between the complications and complications-free groups. On the other hand, in the cirrhotic patients, the recurrence-free survival and overall survival of the complications-free group were significantly longer than those of the complications group.

Conclusions

In the noncirrhotic patients, surgical complications had no prognostic effect, whereas they had a significant survival impact in the cirrhotic patients. The surgical strategy for HCC should be based on the patient’s pathological background.

Keywords

Liver Resection Cirrhotic Patient Fresh Freeze Plasma Retinol Binding Protein Pugh Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors thank Daniel Mrozek (Medical English Service, Kyoto, Japan) for his help preparing this manuscript. Part of this study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (No. 23591993) and a Grant from the Yuasa Memorial Foundation to T. Mizuguchi.

Conflict of interest

None

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Toru Mizuguchi
    • 1
    Email author
  • Masaki Kawamoto
    • 1
  • Makoto Meguro
    • 1
  • Yukio Nakamura
    • 1
  • Shigenori Ota
    • 1
  • Thomas T. Hui
    • 2
  • Koichi Hirata
    • 1
  1. 1.Department of Surgery I, Sapporo Medical University HospitalSapporo Medical University School of MedicineSapporoJapan
  2. 2.Department of SurgeryChildren’s Hospital & Research Center OaklandOaklandUSA

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