title: Perioperative non-tumorous factors associated with survival in HCC patients who underwent hepatectomy.
abstract: OBJECTIVE
  To clarify perioperative factors associated with poor survival following hepatectomy.
  
  
  METHODS
  Clinical parameters and stress score, including surgical stress score (SSS) and comprehensive risk score (CRS) were examined from 183 hepatocellular carcinoma patients who underwent hepatectomy.
  
  
  RESULTS
  Factors associated with tumor relapse were increased blood loss/weight, uncontrolled ascites and grade B liver damage (p<0.05). Ascites was identified as an independent risk factor by multivariate logistic regression analysis. Increased blood loss/weight, transfusion, high SSS, high CRS, ascites, and grade B liver damage were associated with poor disease-free survival (p<0.05). Increased blood loss/weight, transfusion, ascites, and grade B liver damage were associated with poor overall survival (p<0.05), and ascites, transfusion, male sex and grade B liver damage were identified as independent risk factors.
  
  
  CONCLUSIONS
  Reducing blood loss and avoiding transfusion appear important for improving prognosis. Maintenance of liver function is necessary in cases showing poor liver function and uncontrolled ascites.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 8528501, Japan. a-nanasm@net.nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Keiko
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Kouki
authors.initials: K
authors.lastname: Wakata
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tominaga
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome