Prognostic value of postoperative complication for early recurrence after curative resection of hepatocellular carcinoma

Hepatobiliary Pancreat Dis Int. 2018 Aug;17(4):323-329. doi: 10.1016/j.hbpd.2018.03.016. Epub 2018 Mar 29.

Abstract

Background: Postoperative complications may adversely affect oncological outcomes. The aim of this study was to evaluate the impact of postoperative complications on early-phase recurrence after curative resection for hepatocellular carcinoma (HCC).

Methods: We included 145 HCC patients who underwent initial and curative resection between January 2004 and December 2013. Postoperative complications of grade III or higher based on Clavien-Dindo classification were defined as clinically relevant postoperative complications. Recurrence within two years after hepatectomy was defined as early-phase recurrence.

Results: Thirty-eight patients (26%) developed postoperative complications. The only predictive factor for postoperative complication was longer operative duration (P = 0.037). The disease-specific survival rate of patients with complication was lower than that of patients without complications (P = 0.015). Early-phase recurrence was observed in 20/38 (53%) patients who suffered postoperative complications and 36/107 (34%) patients with no complications, which was statistically significant (P = 0.039). Multivariate analysis identified four factors contributing to early-phase recurrence: high serum AFP level (P = 0.042), multiple tumors (P < 0.001), poor differentiation (P = 0.036) and presence of postoperative complication (P = 0.039).

Conclusions: Postoperative complication is an independent prognostic factor for early-phase recurrence after curative resection of HCC. Close observation of patients with postoperative complications may be a necessary treatment strategy for HCC.

Keywords: Complications; Hepatocellular carcinoma; Neoplasm metastasis; Risk factors.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / secondary
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Hepatectomy / adverse effects*
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Operative Time
  • Postoperative Complications / etiology*
  • Progression-Free Survival
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome