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

• Published in: Hepatobiliary & pancreatic diseases international Vol. 17; no. 4; pp. 323 - 329
• Main Authors: Amisaki, Masataka, Saito, Hiroaki, Tokuyasu, Naruo, Sakamoto, Teruhisa, Honjo, Soichiro, Fujiwara, Yoshiyuki
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01-08-2018; Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8503, Japan
• Subjects: Aged; Carcinoma, Hepatocellular - secondary; Carcinoma, Hepatocellular - surgery; Complications; Female; Hepatectomy - adverse effects; Hepatocellular carcinoma; Humans; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Middle Aged; Neoplasm metastasis; Neoplasm Recurrence, Local; Operative Time; Postoperative Complications - etiology; Progression-Free Survival; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Hepatocellular carcinoma; Neoplasm metastasis; Complications; Risk factors
• ISSN: 1499-3872
• DOI: 10.1016/j.hbpd.2018.03.016

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).
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.
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).
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.