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World Journal of Surgery

Published in:

01-01-2014

The Impact of Posthepatectomy Liver Failure on the Recurrence of Hepatocellular Carcinoma

Authors: Kohta Iguchi, Etsuro Hatano, Kenya Yamanaka, Shiro Tanaka, Kojiro Taura, Shinji Uemoto

Published in: World Journal of Surgery | Issue 1/2014

Abstract

Background

Patients with hepatocellular carcinoma (HCC) who underwent hepatectomy often developed an intrahepatic recurrence, even though it was a curative one. The relationship between surgery-induced liver damage and the recurrence of HCC has not been described. This study evaluated whether posthepatectomy liver failure, as defined by the International Study Group of Liver Surgery, affected the recurrence of HCC.

Methods

We performed a retrospective cohort study of 488 patients with HCC who underwent hepatectomy between 2004 and 2012 at Kyoto University Hospital. Early posthepatectomy liver failure (EPLF) was defined as liver failure occurring between postoperative days 5 and 10. The patients were divided into an EPLF group and a non-EPLF group. Disease-free survival (DFS) was compared between these groups. The influences of host-related, surgery-related, and tumor-related factors on patient outcomes were evaluated using multivariate analyses.

Results

The EPLF group and the non-EPLF group contained 153 and 335 patients, respectively. The probability of DFS was significantly increased in the non-EPLF group (median: 574 days) compared to the EPLF group (median: 348 days) (hazard ratio, HR [95 % confidence interval, CI] 1.61 [1.29–2.00]). The multivariate analysis revealed that EPLF was an independent factor for DFS (HR [95 % CI] 1.43 [1.13–1.81]), besides the factors previously described, including fibrosis (1.32 [1.05–1.67]), stage (1.85 [1.34–2.51]), tumor differentiation (1.46 [1.11–1.89]), and des-γ-carboxyprothrombin (1.39 [1.10–1.74]).

Conclusions

EPLF was associated with postoperative HCC recurrence. The prevention of EPLF might improve the prognosis of patients with HCC.

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Title: The Impact of Posthepatectomy Liver Failure on the Recurrence of Hepatocellular Carcinoma
Authors: Kohta Iguchi
Etsuro Hatano
Kenya Yamanaka
Shiro Tanaka
Kojiro Taura
Shinji Uemoto
Publication date: 01-01-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 1/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-2247-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Impact of Posthepatectomy Liver Failure on the Recurrence of Hepatocellular Carcinoma

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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