title: Preoperative total cholesterol predicts postoperative outcomes after partial hepatectomy in patients with chronic hepatitis B- or C-related hepatocellular carcinoma.
abstract: BACKGROUND
  Total cholesterol (TC) can reflect the degree of liver damage in patients with chronic hepatitis B or C; its role in evaluating liver functional reserve and predicting postoperative complications remains unknown.
  
  
  METHODS
  The prospectively collected data of 996 consecutive patients with chronic hepatitis B or C undergoing partial hepatectomy for hepatocellular carcinoma in a tertiary institution were retrospectively reviewed. The relationship between preoperative TC and postoperative liver insufficiency, morbidity and mortality were analyzed.
  
  
  RESULTS
  TC showed significant correlation with postoperative complications on receiver operating characteristic curves, with area under the curve of 0.81 (P < .001), 0.79 (P < .001), and 0.85 (P < .001) for postoperative liver insufficiency, morbidity, and mortality, respectively. Using the calculated cutoff at 2.80 mmol/L, Patients with low TC had worse preoperative liver functional reserve and suffered from more postoperative complications when compared with patients with normal TC (≥2.8 mmol/L). Multivariate analysis revealed that low preoperative TC was more powerful in predicting poor postoperative outcomes than Child-Pugh's classification, indocyanine green (ICG) retention test, and Mayo End-Stage Liver Disease (MELD) score. It was an independent risk factor for postoperative morbidity (odds ratio [OR], 4.87; P < .001) and mortality (OR, 14.60; P < .001).
  
  
  CONCLUSIONS
  Among patients with chronic virus B or C hepatitis receiving partial hepatectomy, a low TC (<2.8 mmol/L) predicted poor postoperative outcomes. It was better than Child-Pugh's classification, ICG, and MELD score in the prediction of postoperative complications, and was useful in the preoperative evaluation of liver functional reserve.
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: W Y
authors.initials: WY
authors.lastname: Lau
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Bixiang
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hongping
authors.initials: H
authors.lastname: Luo
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: ChenXP@medmail.com.cn.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery* / Q000821:virology; D002648:Child; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000401:mortality; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002784:Cholesterol