Open AccessLiver Resection for Hepatocellular Carcinoma in Patients with Renal Dysfunction
Author(s) -
Shirata Chikara,
Hasegawa Kiyoshi,
Kokudo Takashi,
Yamashita Suguru,
Yamamoto Satoshi,
Arita Junichi,
Akamatsu Nobuhisa,
Kaneko Junichi,
Sakamoto Yoshihiro,
Kokudo Norihiro
Publication year - 2018
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-018-4698-3
Subject(s) - medicine , hepatocellular carcinoma , cardiothoracic surgery , gastroenterology , pleural effusion , renal function , hepatectomy , cardiac surgery , incidence (geometry) , abdominal surgery , survival rate , resection , surgery , vascular surgery , physics , optics
Background The aim of this study was to evaluate the feasibility of liver resection in hepatocellular carcinoma (HCC) patients with preoperative renal dysfunction (RD). Methods Data from 735 patients undergoing primary liver resection for HCC between 2002 and 2014 were analyzed. Short‐ and long‐term outcomes were compared between the RD group, defined by a preoperative estimated glomerular filtration rate of <45 mL/min/1.73 m 2 , and the non‐RD group. Results Sixty‐two patients had RD. The incidence of postoperative pleural effusion (24 vs. 11%; P = 0.007) and major complications (Clavien–Dindo III–V; 31 vs. 15%; P = 0.003) were significantly higher in RD patients. In RD patients with Child‐Pugh A, 90‐day mortality rate (1.9%) and median survival time (6.11 years) were comparable to that of non‐RD patients. In contrast, RD patients with Child‐Pugh B had a very high 90‐day mortality rate (22.2%), and a significant shorter median survival time compared to non‐RD patients (1.19 vs. 4.84 years; P = 0.001). Conclusions Liver resection for Child‐Pugh A patients with RD is safe and has comparable oncological outcomes compared to non‐RD patients. However, selection of liver resection candidates from Child‐Pugh B patients with RD should be stricter.