title: Safety of hepatic resection for hepatocellular carcinoma in obese patients with cirrhosis.
abstract: OBJECTIVE
  This study aimed at investigating the safety of hepatic resection for hepatocellular carcinoma (HCC) in obese patients with cirrhosis in Japan.
  
  
  METHODS
  We reviewed the clinical records of 202 patients with liver cirrhosis, who underwent hepatic resection for HCC between January, 2001 and August, 2011. The patients were divided into three groups according to their body mass index (BMI): the normal body weight (BMI < 24.9 kg/m(2)), obese class I (BMI 25.0-29.9 kg/m(2)), and obese class II (BMI ≥ 30 kg/m(2)) groups. We compared the patient backgrounds, intraoperative factors, and postoperative complications among the three groups.
  
  
  RESULTS
  The normal body weight, obese class I, and obese class II groups comprised 138 (68.3 %), 55 (27.2 %), and 9 (4.5 %) patients, respectively. The incidence of non-B non-C cirrhosis was higher in the obese class II group (22 %) than in the normal body weight group (14 %, p = 0.034). Intraoperative blood loss tended to be higher in the obese class II patients than in the other two groups. Postoperative complications and mortality did not differ significantly among the three groups. According to multivariate analysis, obesity was not a risk factor for postoperative complications (Clavien-Dindo classification Grade III or higher) or mortality.
  
  
  CONCLUSIONS
  Hepatic resection for HCC can be performed safely in obese patients with cirrhosis.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan, sgtanaka@hyo-med.ac.jp.
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iimuro
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Hirano
authors.forename: Seikan
authors.initials: S
authors.lastname: Hai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzumura
authors.forename: Ikuo
authors.initials: I
authors.lastname: Nakamura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kondo
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000145:classification / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D012449:Safety