Concurrent Cholecystectomy Is Associated with a Lower Risk of Recurrence after Curative Resection in Early-Stage Hepatocellular Carcinoma: A 10 Year Observational Single-Center Study

Abstract

Background: Cholecystectomy has been reported to be associated with increased risk of developing hepatocellular carcinoma (HCC). However, there is little information about the impact of cholecystectomy on the outcome of HCC. Aims: To evaluate the long-term effect of concurrent cholecystectomy on recurrence and overall survival in HCC after curative hepatectomy. Patients and Methods: We retrospectively enrolled 857 patients with BCLC stage 0 or A HCC who underwent primary resection from January 2001 to June 2016. The impact of concurrent cholecystectomy on overall survival (OS) and recurrence-free survival (RFS) were analyzed by Cox’s proportional hazards models after one-to-one propensity score matching (PSM). Results: Of the 857 patients, 539 (62.9%) received concurrent cholecystectomy (cholecystectomy group) and 318 (37.1%) did not (non-cholecystectomy group). During the mean follow-up period of 75.0 months, 471 (55.0%) patients experienced recurrence, and 321 (37.5%) died. RFS and OS were not significantly different between the groups. After PSM, a total of 298 patients were enrolled in each group. RFS was significantly higher in the cholecystectomy than non-cholecystectomy group (p = 0.044). In multivariate analysis, age (p = 0.022), serum AFP (p = 0.008), liver cirrhosis (p < 0.001), diabetes (p = 0.004), tumor number (p = 0.005), tumor size (p = 0.002), histological grade (p = 0.001), microvascular invasion (p < 0.001) and cholecystectomy (p = 0.021) were independent risk factors for HCC recurrence. However, there were no significant differences in OS between the cholecystectomy and non-cholecystectomy groups. Conclusions: Concurrent cholecystectomy may reduce recurrence in early-stage HCC after curative resection. Further studies are needed to validate our results.

Cholecystohepatic shunt pathway reduces secondary bile acid accumulation to enhance natural killer T cell‐mediated anti‐hepatocellular carcinoma immunity

“…In a retrospective study involving 3933 patients with HCC, 9 the multifactorial analysis showed that cholecystectomy was an independent risk factor for early recurrence after hepatectomy in patients with early stage (BCLC stage O/A) HCC; however, it did not affect OS. In another retrospective study of 857 patients with early-stage HCC (BCLC stage 0/A), 10 after 1:1 PSM, multifactorial analysis demonstrated that cholecystectomy reduced recurrence after hepatic resection for early-stage HCC, with no difference in OS between the two groups. Furthermore, cholecystectomy was found to promote hepatic distant recurrence after microwave ablation in patients with HCC and was associated with elevated GGT levels.…”

“…Furthermore, intraoperative co-cholecystectomy has been suggested to impact the recurrence and survival of patients with HCC after hepatectomy. [6][7][8][9][10][11] Despite this, sufficient evidence to elucidate the relationship between cholecystectomy and HCC is lacking. To address this gap, we collected case data from patients with HCC in our hospital to explore the relationship between cholecystectomy and the postoperative recurrence and survival of patients with HCC after hepatectomy.…”

Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection

“…The results of this study showed that younger age (≤ 50 years old) was an important clinical factor for predicting early recurrence of HCC after surgery (which is consistent with previous studies). Chen et al [ 15 ] reported that age was an independent risk factor for HCC recurrence. Zhang et al [ 16 ] reported that the recurrence rate of liver cancer in younger patients was higher after surgery.…”

Exploring the mechanism of bioactive components of Prunella vulgaris L. in treating hepatocellular carcinoma based on network pharmacology

“…In addition, smoking, alcoholism, non‐alcoholic fatty liver disease, obesity, and aflatoxin exposure may also lead to HCC (Cai et al., 2023). Even though surgical operations, interventional therapy, chemoradiotherapy and liver transplantation improve the prognosis of the patients, HCC recurrence rate and mortality are still high due to the high aggressiveness and treatment resistance (Chen et al., 2021; Chen et al., 2022). Traditional Chinese medicine (TCM) has been used clinically in Asia for more than 2000 years, and as has gradually been accepted by non‐Chinese people (Wang et al., 2023).…”