Hepatectomy Provides Good Long-Term Outcomes for Hepatocellular Carcinoma Patients With Portal Hypertension: A Propensity Score Matching Analysis

Abstract

Background: The role of hepatectomy in hepatocellular carcinoma (HCC) with portal hypertension (PH) remains controversial. This study aimed to evaluate the effect of hepatectomy on overall survival (OS) of HCC patients with PH.Methods: A total of 1651 HCC initially treated with hepatectomy were retrospectively reviewed and divided into PH group (n=157) or non-PH group (n=1494). Propensity score matching (PSM) was conducted to match the baseline characteristics of the PH group and non-PH group. Results: The PH group presented a similar OS (p=0.29) and recurrence free survival (RFS) (p=0.83) compared with non-PH group after initial hepatectomy before PSM. After PSM processing, the baseline characteristics were highly comparable for both groups (133 patients in each group). The PH group also presented a similar OS (p=0.81) and RFS (p=0.65) compared with non-PH group after initial hepatectomy. After PSM, multivariate analysis identified tumor size (>5 cm) (p=0.02), macro-venous invasion (p < 0.001), AST (>37 U/L) (p =0.008) as independent risk factors for OS.Conclusions: Hepatectomy provides good long-term outcomes for HCC patients with PH. PH should not be regarded as a contraindication for hepatectomy in HCC patients.