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Surgical Outcomes in Patients with Hepatocellular Carcinoma Associated with Metabolic Syndrome

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Abstract

Background

Only a few papers have focused on the surgical outcomes of patients with hepatocellular carcinoma (HCC) associated with the metabolic syndrome. We compared the outcomes of patients with metabolic HCC with those of patients with non-B, non-C HCC associated with other etiologies.

Methods

Metabolic HCC was defined as HCC arising in patients with at least three of the following metabolic disorders: central obesity, dyslipidemia, hypertension, and diabetes mellitus. A total of 246 patients with non-B, non-C HCC were divided into three groups: metabolic HCC (n = 35), alcoholic HCC (n = 114), and cryptogenic HCC (n = 97). Clinical characteristics, surgical data, and survival were compared among the three groups.

Results

Metabolic HCC was diagnosed at a significantly higher age than alcoholic (75 vs. 68 years, P = 0.004) and cryptogenic HCCs (75 vs. 71 years, P = 0.027). Postoperative complications occurred significantly higher in patients with metabolic HCC compared with those with cryptogenic HCC (40.0 vs. 22.7 %, P = 0.049). Especially, pulmonary complications were significant in metabolic HCC compared with cryptogenic HCC (22.9 vs. 8.2 %, P = 0.023). The overall survival rates in the metabolic, alcoholic, and cryptogenic HCC groups were 96.7 % (95 % CI, 90.5–100), 96.3 % (95 % CI, 92.8–99.9), and 95.6 % (95 % CI, 91.5–99.9) at 1 year, respectively, and 87.2 % (95 % CI, 74.5–100), 82.9 % (95 % CI, 74.6–92.2), and 84.5 % (95 % CI, 75.7–94.3) at 3 years, respectively (P = 0.84). The disease-free survival rates in each group were 74.4 % (95 % CI, 60.5–91.5), 76.9 % (95 % CI, 69.2–85.5), and 74.3 % (95 % CI, 65.0–84.8) at 1 year, respectively, and 29.3 % (95 % CI, 16.6–51.8), 39.0 % (95 % CI, 29.7–51.2), and 41.1 % (95 % CI, 29.7–56.8) at 3 years, respectively, (P = 0.90).

Conclusions

Metabolic HCC patients have specific risks of postoperative complication related to the metabolic syndrome.

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Acknowledgments

We thank Mr. Peter Star of Medical Network K.K. for assistance in writing the manuscript. This work was mainly supported by a Grant-in-Aid for Scientific Research (A) 24249068 (T.T.) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan.

Conflict of interest

We declare that we have no conflicts of interest.

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Authors and Affiliations

  1. Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610, Japan

    Naoki Yoshida, Tadatoshi Takayama, Yutaka Midorikawa, Tokio Higaki, Hisashi Nakayama & Masamichi Moriguchi

  2. Genome Science Division, Research Center for Advanced Science and Technologies, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8904, Japan

    Shingo Tsuji

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  1. Naoki Yoshida
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  2. Tadatoshi Takayama
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  3. Yutaka Midorikawa
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  4. Tokio Higaki
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  5. Hisashi Nakayama
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  6. Masamichi Moriguchi
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  7. Shingo Tsuji
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Correspondence to Naoki Yoshida.

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Yoshida, N., Takayama, T., Midorikawa, Y. et al. Surgical Outcomes in Patients with Hepatocellular Carcinoma Associated with Metabolic Syndrome. World J Surg 39, 471–477 (2015). https://doi.org/10.1007/s00268-014-2828-0

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  • DOI: https://doi.org/10.1007/s00268-014-2828-0

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