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Hepatic Resection for Hepatocellular Carcinoma Patients on Hemodialysis for Uremia: A Nationwide Cohort Study

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Abstract

Background

The association between uremia and survival outcomes of patients undergoing hepatic resection for hepatocellular carcinoma (HCC) has not been well investigated, particularly for perioperative complications. This nationwide cohort study aimed to compare survival outcomes as well as perioperative mortality and complications between uremia-HCC patients and non-uremia-HCC patients who underwent hepatic resection.

Methods

Using Taiwan’s National Health Institute Research Database, 149 uremia-HCC patients who underwent hepatic resection between 1996 and 2008 were enrolled. The control group comprised 596 HCC patients who also received hepatic resection during the same time period. The two groups were matched for age, gender, viral hepatitis status, and underlying liver cirrhosis. Disease-free survival, overall survival, and perioperative complications were compared between the two groups.

Results

For the uremia-HCC cohort, the 1-, 5-, and 10-year overall and disease-free survival rates were 86, 52, and 38 %, as well as 77, 27, and 18 %, respectively. The survival outcomes were comparable between uremia-HCC cohort and the HCC cohort, regardless of extent of hepatic resection. As for perioperative complications, the uremia-HCC cohort had a higher risk of postoperative infections requiring invasive interventions as well as an increased risk of life-threatening heart-associated complications, compared to the HCC cohort.

Conclusions

Uremia did not influence survival outcomes between the uremia-HCC and the HCC cohorts, irrespective of extent of hepatic resection. This study urges a better perioperative care strategy to avoid potential cardiac and infectious complications in uremia-HCC patients.

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Abbreviations

HCC:

Hepatocellular carcinoma

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Acknowledgments

This study was supported in part by the National Health Research Institute (grant number: PH-100-PP-54) and the Taichung Veterans General Hospital (Grant number: TCVGH-1003303C), Taiwan.

Disclosure

All authors have nothing to disclose, including any potential financial, professional, or personal conflicts that are relevant to the manuscript. There is no study sponsor involving in the study design in the collection, analysis, and interpretation of date.

Author information

Authors and Affiliations

  1. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan

    Chun-Chieh Yeh & Teng-Yu Lee

  2. Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan

    Chun-Chieh Yeh & Long-Bin Jeng

  3. School of Medicine, China Medical University, Taichung, Taiwan

    Chun-Chieh Yeh

  4. Division of Gastroenterology, National Taiwan University Hospital, Taipei, Taiwan

    Jaw-Town Lin & Ming-Shiang Wu

  5. Department of Internal Medicine, E-Da Hospital and I-Shou University, Kaohsiung County, Taiwan

    Jaw-Town Lin

  6. Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan

    Jaw-Town Lin & Ken N. Kuo

  7. Secondary Surgical Department, General Hospital Georgios Papanikolaou, Thessaloniki, Greece

    Iakovidis Charalampos

  8. Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan

    Tzu-Ting Chen, Teng-Yu Lee, Yi-Ya Liu & Chun-Ying Wu

  9. Faculty of Medicine, School of Medicine, National Yang-Ming University, 155, Sec. 2, Linong Street, Taipei, 112, Taiwan

    Chun-Ying Wu

  10. Department of Public Health, China Medical University, Taichung, Taiwan

    Chun-Ying Wu

  11. Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan

    Chun-Ying Wu

Authors
  1. Chun-Chieh Yeh
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  2. Jaw-Town Lin
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  3. Long-Bin Jeng
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  4. Iakovidis Charalampos
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  5. Tzu-Ting Chen
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  6. Teng-Yu Lee
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  7. Ming-Shiang Wu
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  8. Ken N. Kuo
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  9. Yi-Ya Liu
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  10. Chun-Ying Wu
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Corresponding author

Correspondence to Chun-Ying Wu.

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Yeh, CC., Lin, JT., Jeng, LB. et al. Hepatic Resection for Hepatocellular Carcinoma Patients on Hemodialysis for Uremia: A Nationwide Cohort Study. World J Surg 37, 2402–2409 (2013). https://doi.org/10.1007/s00268-013-2137-z

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  • DOI: https://doi.org/10.1007/s00268-013-2137-z

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