Cholecystectomy is associated with higher risk of early recurrence and poorer survival after curative resection for early stage hepatocellular carcinoma.
Although cholecystectomy has been reported to be associated with increased risk of developing hepatocellular carcinoma (HCC), the association between cholecystectomy and prognosis of HCC patients underwent curative resection has never been examined. Through retrospective analysis of the data of 3933 patients underwent curative resection for HCC, we found that cholecystectomy was an independent prognostic factor for recurrence-free survival (RFS) of patients at early stage (BCLC stage 0/A) (p = 0.020, HR: 1.29, 95% CI: 1.04-1.59), and the 1-, 3-, 5-year RFS rates for patients at early stage were significantly worse in cholecystectomy group than in non-cholecystectomy group (80.5%, 61.8%, 52.0% vs 88.2%, 68.8%, 56.8%, p = 0.033). The early recurrence rate of cholecystectomy group was significantly higher than that of non-cholecystectomy group for patients at early stage (59/47 vs 236/333, p = 0.007), but not for patients at advanced stage (BCLC stage C) (p = 0.194). Multivariate analyses showed that cholecystectomy was an independent risk factor for early recurrence (p = 0.005, HR: 1.52, 95% CI: 1.13-2.03) of early stage HCC, but not for late recurrence (p = 0.959). In conclusion, cholecystectomy is an independent predictor for early recurrence and is associated with poorer RFS of early stage HCC. Removal of normal gallbladder during HCC resection may be avoided for early stage patients.
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China.
Tao
T
Li
Department of Biostatistics, School of Public Health, Shandong University, Jinan, P.R. China.
Shu-Kang
SK
Wang
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China.
Xu-Ting
XT
Zhi
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Jian
J
Zhou
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China.
Zhao-Ru
ZR
Dong
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China.
Zong-Li
ZL
Zhang
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Hui-Chuan
HC
Sun
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Qing-Hai
QH
Ye
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Jia
J
Fan
D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002763:Cholecystectomy / Q000009:adverse effects*; D018572:Disease-Free Survival; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors