Significance of zinc deficiency in patients with hepatocellular carcinoma undergoing hepatic resection

Abstract

Aim: Few reported studies examine the relationship between zinc (Zn) deficiency and short-and long-term outcomes in patients with hepatocellular carcinoma undergoing hepatic resection. Methods:We retrospectively reviewed data from 179 consecutive patients who had undergone curative hepatic resection for hepatocellular carcinoma in our institute between January 2016 and May 2019. Zn deficiency was defined in accordance with the Japanese Society of Clinical Nutrition guidelines. We allocated the participants into two groups according to Zn deficiency status, and analyzed the clinicopathological and short-and long-term outcomes. Results:In this series, 32 patients (17.8%) had Zn deficiency. Zn deficiency was significantly associated with older age, lower serum albumin, higher aspartate aminotransferase, lower hemoglobin, higher creatinine, lower prognostic nutritional index, higher liver fibrosis markers, albumin-bilirubin 2, portal hypertension, larger amount of estimated blood loss, larger amount of maximum ascites, longer hospital stay, postoperative complications, and liver-related complications. Concentrations of liver fibrosis markers were negatively correlated with serum Zn concentrations.Zn deficiency, albumin-bilirubin 2, and non-laparoscopic approach were identified as independent predictors of postoperative complications. Multivariate analyses revealed that the overall survival rate decreased in parallel with decreasing Zn concentrations. Conclusions:In this study, Zn deficiency was significantly associated with poorer liver function, more severe liver fibrosis, higher incidence of postoperative complications, and worse overall survival according to multivariate analysis. Serum Zn status could serve as a new surrogate marker for predicting short-and long-term outcomes in patients undergoing hepatic resection for hepatocellular carcinoma.

The ratio of creatinine and cystatin C estimated glomerular filtration rates as a surrogate marker in patients with hepatocellular carcinoma undergoing hepatic resection

“…Recently, the loss of skeletal muscle mass, termed sarcopenia, was identified as a poor prognostic factor for colorectal liver metastases and liver transplantation 6,7 . We previously published our finding that preoperative sarcopenia was predictive of a worse overall and recurrence‐free survival 8 and also preoperative serum low zinc concentration was predictive of a worse overall and recurrence‐free survival in patients with HCC after hepatic resection 9 . This study planned to search for simpler indicators that predict prognosis of HCC patients.…”

Preoperative zinc status predicts the occurrence and healing time of pancreatic fistula after distal pancreatectomy

“…reported that Zinc deficiency is known to cause head and neck cancer complications, unexpected hospitalizations, and delays in treatment 26,27 . We previously reported that Zn deficiency was significantly related with postoperative complications after hepatectomy and poor prognosis in patients with HCC 28 . In a recent review, Zn deficiency can be related to the development of cancer 29 …”

Preoperative reduced hand grip strength and oral frailty as a predictor of disability in the elderly following hepatobiliary-pancreatic surgery

“…Nishikawa et al showed that serum zinc levels were well strati ed, according to frailty status (i.e., frailty, pre-frailty, and robust) in patients with chronic liver diseases [29]. We previously reported that zinc de ciency is associated with hepatic resection complications in patients with hepatocellular carcinoma [30]. Serum zinc, a microelement, tends to decrease with advancing age [31], and its de ciency is thought to affect taste acuity [32].…”