title: Impact of operative and peri-operative factors on the long-term prognosis of primary liver cancer patients undergoing hepatectomy.
abstract: This study examined the impact of the operative and peri-operative factors on the long-term prognosis of patients with primary liver cancer undergoing hepatectomy. A total of 222 patients with primary liver cancer who underwent hepatectomy were followed up from January 1986 to December 2010 at Chinese PLA General Hospital. The post-operative complication rate was 14.0% for all cases, 13.7% for hepatocellular carcinoma (HCC), 10.0% for cholangiocarcinoma. The 1-, 3-, 5- and 10-year overall survival rates in patients with primary liver cancer after resection were 76.6%, 57.6%, 41.4%, and 21.0%. The survival rates were significantly higher in the HCC group than in the cholangiocarcinoma group (P=0.000), in the non-anatomical resection group than in the anatomical resection group (P=0.005), in the female group than in the male group (P=0.002), in patients receiving no blood transfusion than in those who were given intra-operative blood transfusion (P=0.000), in patients whose intra-operative blood loss was less than 400 mL than in those who intra-operatively lost more than 400 mL (P=0.000). No significant difference was found in the survival rate between the HBsAg-positive group and the HBsAg-negative group (P=0.532). Our study showed that anatomical resection, blood loss and blood transfusion were predictors of poor survival after hepatectomy for primary liver cancer patients, and concomitant hepatitis B virus infection bore no relation with the post-resection survival.
authors.affiliation: Department of General Surgery, Clinical Division of South Building, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Li-Ning
authors.initials: LN
authors.lastname: Xu
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital, Zhengzhou, 450003, China.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Clinical Division of South Building, Chinese PLA General Hospital, Beijing, 100853, China. chaoyue528@sohu.com.
authors.forename: De-Wei
authors.initials: DW
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000601:surgery* / Q000821:virology; D018281:Cholangiocarcinoma / Q000097:blood / Q000473:pathology / Q000601:surgery* / Q000821:virology; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000473:pathology; D011379:Prognosis
chemical_list: D006514:Hepatitis B Surface Antigens
keywords: hepatectomy; influencing factors; perioperative time; primary liver cancer; prognosis