Perioperative change in white blood cell count predicts outcome of hepatic resection for hepatocellular carcinoma.
BACKGROUND
In spite of improvements in surgical management, hepatocellular carcinoma (HCC) still recurs after operation in 60-70% of patients. Therefore, we investigated the relation between perioperative change in white blood cell count (WBC) and tumor recurrence as well as survival in patients with HCC after hepatic resection.


METHODS
Subjects were 53 patients who underwent elective hepatic resection for HCC. We retrospectively examined the relation between perioperative change in WBC and recurrence of HCC as well as overall survival.


RESULTS
Advanced tumor stage and increasing of WBC on postoperative day (POD) 1 were positively associated with worse disease-free survival rate on both univariate and multivariate analysis (P < 0.05). Advanced tumor stage, increasing of WBC on POD 1, and blood transfusion were positively associated with worse overall survival rate on univariate analysis (P < 0.05), while change in WBC was the only independent factor on multivariate analysis (P < 0.05).


CONCLUSIONS
Perioperative change in WBC after elective hepatic resection for HCC is positively associated with recurrence and worse survival.
Fujiwara
Yuki
Y
Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan. sheetan@jikei.ac.jp
Shiba
Hiroaki
H
Furukawa
Kenei
K
Iida
Tomonori
T
Sakamoto
Taro
T
Gocho
Takeshi
T
Wakiyama
Shigeki
S
Hirohara
Shoichi
S
Ishida
Yuichi
Y
Misawa
Takeyuki
T
Ohashi
Toya
T
Yanaga
Katsuhiko
K
D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009369:Neoplasms / Q000601:surgery; D019990:Perioperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome