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Survival analysis after liver resection for hepatocellular carcinoma: A consecutive cohort of 1002 patients
Author(s) -
Lee Eung Chang,
Kim Seong Hoon,
Park Hyeongmin,
Lee Seung Duk,
Lee SoonAe,
Park SangJae
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13632
Subject(s) - medicine , hepatocellular carcinoma , perioperative , cirrhosis , proportional hazards model , hepatectomy , univariate analysis , survival analysis , survival rate , metastasis , gastroenterology , cohort , surgery , multivariate analysis , oncology , cancer , resection
Abstract Background and Aim The improvements in surgical technique and perioperative management in the recent decades may warrant revisit for survival outcomes and prognostic factors after liver resection for hepatocellular carcinoma (HCC). This study aimed to analyze the survival outcomes after liver resection for HCC for a consecutive cohort of 1002 patients. Methods This study was performed by analyzing the clinicopathological and follow‐up data of 1002 consecutive patients who underwent liver resection for HCC from April 2001 to December 2013. Prognostic factors were investigated by univariate and multivariate analysis, using the Cox's proportional hazards model. Results The overall incidence of postoperative complications was 16.1% ( n = 161), with an in‐hospital mortality rate of 0.3% ( n = 3). The rates of 1‐, 3‐, and 5‐year overall survival were 91.9%, 78.9%, and 69.5%, while the rates of 1‐, 3‐, and 5‐year recurrence‐free survival were 71.7%, 51.7%, and 43.7%, respectively. Multivariate analysis showed that patient age, platelet count, intraoperative estimated blood loss (EBL), tumor number, Edmond–Steiner grade, microvascular invasion, major vessel invasion, and intrahepatic metastasis were independent significant prognostic factors affecting the overall survival. Platelet count, intraoperative EBL, maximal tumor size, major vessel invasion, capsule formation, intrahepatic metastasis, cirrhosis, and the pathological stage were independent prognostic factors for recurrence‐free survival. Conclusions Survival of patients with HCC after resection should be stratified by various perioperative clinicopathological factors. Platelet count and intraoperative EBL could be considered as one of the powerful predictors of the prognosis and recurrence of HCC in such patients.