Ann Surg Treat Res.  2017 Nov;93(5):252-259. 10.4174/astr.2017.93.5.252.

Prognostic factors after curative resection hepatocellular carcinoma and the surgeon's role

• You DD
• Kim DG
• Seo CH
• Choi HJ
• Yoo YK
• Park YG

• KMID: 2393990
• DOI: http://doi.org/10.4174/astr.2017.93.5.252

Abstract

PURPOSE
Patient, surgical, and tumor factors affect the outcome after surgical resection for hepatocellular carcinoma (HCC). The surgical factors are only modifiable by the surgeon. We reviewed our experience with curative resection for HCC in terms of surgical factors.
METHODS
After analyses of the prospectively collected clinical data of 256 consecutive patients undergoing surgical resection for HCC, prognostic factors for disease-free survival (DFS) and overall survival (OS) were identified; all patients were stratified by tumor diameters > or <5 cm and their outcomes were compared.
RESULTS
Multivariate analyses showed that microvascular invasion, estimated blood loss, blood transfusion, and the number of tumors were independent adverse prognostic factors for DFS, whereas microvascular invasion, serum alpha fetoprotein, and tumor diameter were independent adverse prognostic factors for OS. Blood transfusion had borderline significance (P = 0.076). After stratification by tumor diameter, blood transfusion was only associated with poor DFS and OS in patients with tumor diameters > 5 cm.
CONCLUSION
Tumor recurrence after liver resection for HCC depends on tumor status, bleeding, and transfusions, which subsequently lead to poor patient survival. Surgeons can help improve the prognosis of patients by minimizing blood loss and transfusion, particularly in patients with larger tumors.

Keyword

Hepatocellular carcinomas; Surgeons; Liver cirrhosis; Prognosis; Hepatectomy

MeSH Terms

alpha-Fetoproteins
Blood Transfusion
Carcinoma, Hepatocellular*
Disease-Free Survival
Hemorrhage
Hepatectomy
Humans
Liver
Liver Cirrhosis
Multivariate Analysis
Prognosis
Prospective Studies
Recurrence
Surgeons
alpha-Fetoproteins

Figure

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  Fig. 1 Disease-free survival (A) and overall survival (B) of all patients at 1, 3, and 5 years were 69%, 52%, 38% and 90%, 78%, 74%, respectively.

• 

  Fig. 2 Disease-free survival (A) and overall survival (B), according to transfusion in patients with tumor > 5 cm.

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