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Operative Blood Loss Independently Predicts Recurrence and Survival After Resection of Hepatocellular Carcinoma
- Source :
- Annals of Surgery. 249:617-623
- Publication Year :
- 2009
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2009.
-
Abstract
- To determine if the degree of blood loss during resection of hepatocellular carcinoma (HCC) is predictive of recurrence and long-term survival.Several studies have addressed the impact of blood transfusion on survival and recurrence after liver resection for HCC. However, the independent effect of intraoperative estimated blood loss (EBL) on oncologic outcome is unclear.From our prospective database, we identified 192 patients who had a partial hepatectomy for HCC from 1985 to 2002. Clinicopathologic predictors of EBL were identified using logistic regression. Overall survival (OS), disease-specific survival (DSS), and recurrence free survival (RFS) were assessed using the Kaplan-Meier and Cox regression methods.The median patient age was 64 (range, 19-86) and 66% were men. All patients had histologically proven HCC. The median follow-up time was 34 months (range, 1-297). Factors associated with increased EBL on multivariate analysis were male gender, vascular invasion, extent of hepatectomy, and operative time (P0.01). EBL and vascular invasion were independent predictors of OS and DSS. Only EBL was significantly associated with RFS on multivariate analysis (P = 0.02). Additionally, we found a significant inverse correlation between increasing levels of EBL and length of DSS (P = 0.01).The magnitude of EBL during HCC resection is related to biologic characteristics of the tumor as well as the extent of surgery. Increased intraoperative blood loss during HCC resection is an independent prognostic factor for tumor recurrence and death.
- Subjects :
- Adult
Male
medicine.medical_specialty
Carcinoma, Hepatocellular
Blood transfusion
medicine.medical_treatment
Blood Loss, Surgical
Risk Assessment
Young Adult
Postoperative Complications
Sex Factors
Predictive Value of Tests
medicine
Carcinoma
Hepatectomy
Humans
Registries
Survival analysis
Aged
Neoplasm Staging
Probability
Retrospective Studies
Aged, 80 and over
business.industry
Liver Neoplasms
Age Factors
Cancer
Middle Aged
Prognosis
medicine.disease
Survival Analysis
digestive system diseases
Surgery
Predictive value of tests
Hepatocellular carcinoma
Multivariate Analysis
Female
Neoplasm Recurrence, Local
Liver cancer
business
Subjects
Details
- ISSN :
- 00034932
- Volume :
- 249
- Database :
- OpenAIRE
- Journal :
- Annals of Surgery
- Accession number :
- edsair.doi.dedup.....026c30a939e4454c951bf8c3b4a7a728