Correlation between preoperative serum concentration of type IV collagen 7s domain and hepatic failure following resection of hepatocellular carcinoma.
OBJECTIVE
To determine the predictive value of the preoperative serum concentration of type IV collagen 7s domain (7s collagen) for postoperative hepatic failure in patients undergoing liver resection for hepatocellular carcinoma.


BACKGROUND
Clear and reliable criteria for predicting hepatic failure after liver resection are needed. The serum 7s collagen concentration correlates with the histologic degree of active hepatitis and hepatic fibrosis and may predict the regenerative potential of the liver.


METHODS
Potential risk factors for postoperative hepatic failure, including the serum 7s collagen concentration, were evaluated in 251 patients who underwent liver resection for hepatocellular carcinoma. Prognostic significance was determined by univariate and multivariate analyses.


RESULTS
Hepatic failure developed postoperatively in 25 patients, 4 of whom died. The serum 7s collagen concentration correlated with the histologic degree of hepatitis activity and hepatic fibrosis. The serum 7s collagen concentration was a risk factor for postoperative hepatic failure by univariate analysis and was the only risk factor on multivariate analysis. No patient with a serum 7s collagen concentration <12 ng/mL died of postoperative hepatic failure, and all 4 patients who died had a serum 7s collagen concentration >or=12 ng/mL.


CONCLUSIONS
The preoperative serum 7s collagen concentration correlated independently with hepatic failure following liver resection for hepatocellular carcinoma. Patients whose serum 7s collagen is >or=12 ng/mL are poor candidates for hepatic resection.
Kubo
Shoji
S
Department of Gastroenterological and Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m7696493@msic.med.osaka-cu.ac.jp
Tsukamoto
Tadashi
T
Hirohashi
Kazuhiro
K
Tanaka
Hiromu
H
Shuto
Taichi
T
Takemura
Shigekazu
S
Yamamoto
Takatsugu
T
Uenishi
Takahiro
T
Ogawa
Masao
M
Kinoshita
Hiroaki
H
D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery*; D024141:Collagen Type IV / Q000097:blood*; D000075202:Contraindications; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers; D024141:Collagen Type IV