Background and ObjectivesThe impact of metabolic syndrome (MetS) on surgical outcome, mostly in patients with HBV‐related hepatocellular carcinoma (HCC) who underwent hepatectomy.MethodsA propensity score matching analysis was conducted. Patients were categorized into two groups MetS‐related hepatocellular carcinoma (MetS‐HCC) and 1:1 matched non‐MetS‐related HCC (non‐MetS‐HCC). Surgical outcomes were compared between the two groups.ResultsSeventy‐four MetS‐HCC patients and 74 propensity score‐matched non‐MetS‐HCC patients were selected for analysis. The incidence of surgical site infection was higher in the MetS‐HCC group than in the non‐MetS‐HCC group (12.16% vs 0%, P < .005). There was no difference in the recurrence‐free survival and overall survival between patients in the MetS‐HCC group and in non‐MetS‐HCC group (P > .05). Microvascular invasion and severe postoperative complications were independent risk factors for recurrence‐free survival and overall survival.ConclusionsHepatectomy for patients with mostly HBV‐related HCC in the presence of MetS can result in a higher rate of postoperative surgical site infection compared with those in the absence of MetS, but long‐term survival rates are comparable.

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