Negative Impact of Blood Transfusion on Recurrence and Prognosis of Hepatocellular Carcinoma After Hepatic Resection

Shiba, Hiroaki; Ishida, Yuichi; Wakiyama, Shigeki; Iida, Takuya; Matsumoto, Michinori; Sakamoto, Taro; Ito, Ryusuke; Gocho, Takeshi; Furukawa, Kiyonori; Fujiwara, Yuki; Hirohara, Shoichi; Misawa, Takeyuki; Yanaga, Katsuhiko

doi:10.1007/s11605-009-0963-y

Cited by 88 publications

(65 citation statements)

References 61 publications

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“…Numerous studies reported that blood transfusion causes nonspecific immunosuppression, and affects postoperative complications and prognosis of HCC [25,26]. It is reported that blood transfusion is associated with increased incidence of HCC recurrence especially in early stages (I or II) and absence of vascular invasion [27]. In our study, perioperative blood transfusion was a significant predictor of tumour recurrence.…”

Section: Discussionsupporting

confidence: 57%

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Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Wahab

Shehta

Hamed

et al. 2014

EAJM

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Objective: Egypt is one of the hot spots in the international map of Hepatocellular carcinoma (HCC), which is where hepatitis C virus (HCV) infection is the major risk factor in development of HCC (80%). Due to low organ donation rates and lack of deceased liver transplantation, hepatic resection is the main line of treatment for HCC patients with sufficient liver reserve. We introduce our experience with patients who had HCV related HCC who underwent hepatic resection to determine various predictors of tumour recurrence in this group. This is the first study to come from a country where chronic HCV hepatitis is endemic. Materials and Methods:This is a retrospective cohort study of 208 cases of HCC in hepatitis C virus positive patients with cirrhotic livers who underwent first-time liver resection, in Gastroenterology Surgical Centre, Mansoura University, Egypt during the period from January 2002 to December 2011. Shapiro-Wilk test was used to assess normality of data. Predictors of HCC recurrence were assessed by bivariate correlation tests, univariate analysis using the chi-square and t-test and binary logistic regression analysis. A P value <0.05 was considered statistically significant.Results: Tumour recurrence occurred in 88 patients (42.3%). Most of the recurrences occurred within the first year 55 patients (62.5%). The most common site for recurrence was the liver (n=68, 77.3%). Based on the univariate analysis; significant variables predicting tumor recurrence were alpha feto-protein (AFP), blood transfusion, multifocality, cut margin, microvascular invasion, lack of capsule, tumour grade and stage. Based on multivariate analysis, the main variables predicting tumor recurrence were blood transfusion, cut margin, tumour capsule and microvascular invasion. Conclusion:Although the predictors of recurrence are the same for both HBV and HCV related HCC, the rate and aggressiveness of recurrence are higher in HCV related HCC.Key Words: HCV related HCCs, liver resection, recurrent HCC Özet Amaç: Mısır; hepatit C virüsü (HCV) enfeksiyonunun Hepatocellular karsinomun (HCC) görülmesinde önemli (% 80) bir risk faktörü olduğu, uluslararası HCC haritasındaki sıcak noktalardan biridir. Organ bağışı oranlarının düşük olması ve kadavradan karaciğer nakli eksikliği sebebiyle, karaciğer rezeksiyonu, yeterli karaciğer rezervi olan HCC hastalarının tedavisinde ana yöntemdir. Bu grupta HCV'ye bağlı HCC'si olan hastalarda tümör nüksünün çeşitli faktörlerini araştırmak için karaciğer rezeksiyonu deneyimimizi aktarmak amacındayız. Bu, kronik HCV hepatitinin endemik olduğu bir ülkeden gelen ilk çalış-madır. Gereç ve Yöntem:Bu, Ocak 2002-Aralık 2011 süresince Mısır'ın Mansoura Üniversitesi, Gastroenterolojik Cerrahi Merkezinde ilk kez karaciğer rezeksiyonu yapılan sirotik karaciğerli HCC, hepatit C virüsü pozitif hastalarda 208 vakanın retrospektif kohort çalışmasıdır. Verilerin normalliğini değerlendirmek için Shapiro-Wilk testi kullanılmıştır. HCC nüks prediktörleri ikili korelasyon testleri, tek değişkenli ki-kare ve...

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Section: Discussionsupporting

confidence: 57%

“…In our study, perioperative blood transfusion was a significant predictor of tumour recurrence. Several studies reported that perioperative blood transfusions are significantly associated with increased the incidence of tumour recurrence irrespective to its viral aetiology [13,[27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Wahab

Shehta

Hamed

et al. 2014

EAJM

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“…Therefore, it is important to clarify the predictor of HCC recurrence and prognosis for decision making in additional adjuvant treatment after hepatic resection, preoperatively. Several investigators have reported tumor size, vascular invasion, intrahepatic metastasis, tumor markers, excessive blood loss, and allogenic blood transfusion as factors associated with recurrence of HCC (4)(5)(6)(7). Unlike other solid malignancies, the prognosis of HCC is not solely dependent on tumor burden but also adversely influenced by impaired liver function secondary due to the underlying pathogenic condition (8).…”

Section: Introductionmentioning

confidence: 99%

Glasgow prognostic score predicts therapeutic outcome after hepatic resection for hepatocellular carcinoma

Shiba¹,

Horiuchi²,

Sakamoto³

et al. 2017

Oncology Letters

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Abstract. Systemic inflammation, as evidenced by the Glasgow prognostic score (GPS), predicts cancer-specific survival in various cancer types. The aim of this study was to evaluate the significance of the GPS in the therapeutic outcome of the patient following surgical resection for hepatocellular carcinoma. In total, 144 patients underwent surgical resection for hepatocellular carcinoma. For the assessment of systemic inflammatory response using the GPS, patients were classified into three groups: Patients with normal serum albumin (<3.5 g/dl) and normal serum C-reactive protein (CRP) (≤1.0 mg/dl) were classified as GPS 0 (n=76), those with low serum albumin (<3.5 g/dl) or elevated serum CRP (>1.0 mg/dl) were classified as GPS 1 (n=58), and those with low serum albumin (<3.5 g/dl) and elevated serum CRP (>1.0 mg/dl) were classified as GPS 2 (n=10). Retrospectively, the relationship between patient characteristics including GPS, disease-free as well as overall survival were investigated. In disease-free survival, GPS 2 (P=0.019), with a tumor number ≥3 (P=0.004), and positive portal or venous invasion (P= 0.034) were independent predictors of cancer recurrence in multivariate analysis. In overall survival, GPS 1 (P= 0.042), GPS 2 (P<0.001) and positive portal or venous invasion (P<0.001) were independent predictors of poor patient outcome according to multivariate analysis. To conclude, the GPS in patients with hepatocellular carcinoma is an independent prognostic predictor after hepatic resection.

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“…Shiba et al (30) revealed an increased rate of pulmonary complications for patients who received blood products in hepatic resections for hepatocellular carcinoma. Additionally, early postoperative extubation seems to be associated with faster liver recovery after liver surgery.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Serum Bilirubin and Lactate Levels Predict Postoperative Morbidity and Mortality in Liver Surgery: A Single-Center Evaluation

et al. 2014

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Background and Aims: in spite of huge developments in liver surgery during the last decades, morbidity and mortality continue to pose problems in this field. the aim of this study was to identify preoperative predictors for postoperative mortality and morbidity in liver surgery.Material and Methods: in a single-center study, an extensive analysis of a prospective database, including clinical criteria and laboratory tests of patients undergoing liver surgery between July 2007 and July 2012 was performed. cutoff values of selected laboratory tests were calculated.Results: in all, 337 patients were included in the study. univariate analysis showed a statistically significant association of preoperative bilirubin, lactate, hemoglobin levels, platelet count, and prothrombin time with postoperative morbidity and mortality. multivariate analysis revealed preoperatively elevated serum bilirubin and lactate levels as independent predictors for increased postoperative morbidity and mortality after liver surgery.Conclusions: the identified laboratory values showed a statistically significant association with postoperative morbidity and mortality in liver surgery and might be helpful in preoperative patient selection.

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Negative Impact of Blood Transfusion on Recurrence and Prognosis of Hepatocellular Carcinoma After Hepatic Resection

Abstract: Transfusion of blood products is associated with increased recurrence rate and worse survival after elective hepatic resection for patients with hepatocellular carcinoma.

Cited by 88 publications

References 61 publications

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

Glasgow prognostic score predicts therapeutic outcome after hepatic resection for hepatocellular carcinoma

Preoperative Serum Bilirubin and Lactate Levels Predict Postoperative Morbidity and Mortality in Liver Surgery: A Single-Center Evaluation

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