title: Prognostic significance of postoperative complications after hepatectomy for hepatocellular carcinoma.
abstract: BACKGROUND
  Hepatectomy is one of the best curative therapies for hepatocellular carcinoma (HCC). The negative impact of postoperative complications on long-term survival has been investigated in patients with several kinds of cancers. To clarify the impact of postoperative complications on long-term survival in patients who undergo hepatectomy for HCC, we conducted a comparative analysis of 376 patients using the modified Clavien classification and identified the predictors of postoperative complications.
  
  
  METHODS
  Patients were assigned into two groups: those with (N = 177) and those without complications (N = 199). The clinical data, surgical outcome, and long-term survival of patients were analyzed retrospectively.
  
  
  RESULTS
  The cumulative overall survival rates of the patients with complications were significantly less than those of the patients without complications (P < 0.01). Multivariate logistic regression analysis revealed that intraoperative blood transfusion (P = 0.04), longer operation time (P = 0.02), use of Pringle's maneuver (P < 0.01), and use of the thoraco-abdominal approach (P = 0.01) were independent risk factors for postoperative complications.
  
  
  CONCLUSIONS
  Postoperative complications (major or minor) are one of prognostic indicators in hepatectomy for HCC. The present study suggests that high quality surgical technique to minimize complications will improve the prognosis of HCC.
authors.affiliation: Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Okamura
authors.forename: Shin
authors.initials: S
authors.lastname: Takeda
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Fujii
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Nomoto
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis