Perioperative non-tumorous factors associated with survival in HCC patients who underwent hepatectomy.

Abstract

AIM: To clarify perioperative factors associated with poor survival following hepatectomy. PATIENTS AND METHODS: Clinical parameters and stress score, including surgical stress score (SSS) and comprehensive risk score (CRS) were examined from 183 hepatocellular carcinoma patients who underwent hepatectomy. RESULTS: Factors associated with tumor relapse were increased blood loss/weight, uncontrolled ascites and grade B liver damage (p<0.05). Ascites was identified as an independent risk factor by multivariate logistic regression analysis. Increased blood loss/weight, transfusion, high SSS, high CRS, ascites, and grade B liver damage were associated with poor disease-free survival (p<0.05). Increased blood loss/weight, transfusion, ascites, and grade B liver damage were associated with poor overall survival (p<0.05), and ascites, transfusion, male sex and grade B liver damage were identified as independent risk factors. CONCLUSION: Reducing blood loss and avoiding transfusion appear important for improving prognosis. Maintenance of liver function is necessary in cases showing poor liver function and uncontrolled ascites.