Comparison of hepatectomy with or without hepatic inflow occlusion in patients with hepatocellular carcinoma: a single-center experience.
BACKGROUND
The negative effects of hepatic inflow occlusion (HIO) on postoperative liver function of patients with hepatocellular carcinoma (HCC) after liver resection have been reported. Nevertheless, whether or not HIO could influence the long-term outcomes remains unclear.


METHODS
A total of 396 patients were included in this study and divided into without occlusion (WO) group (N.=112) and HIO group (N.=284). Aiming to minimize influence of selection bias and confounding variables, we used propensity score matching (PSM) of a 0.2 caliper to balance baseline variables. Overall survival (OS) and disease-free survival (DFS) were compared by the Kaplan-Meier method. Independent prognostic factors for OS and DFS were identified by Cox proportional hazards regression model.


RESULTS
PSM were used to generate 101 pairs of patients. After PSM, OS was not significantly different between WO and HIO group (1-year: 86.1% vs. 83.2%; 3-year: 61.4% vs. 61.4%; 5-year: 45.5% vs. 39.6%; P = 0.626). Similar results of DFS were obtained between WO and HIO group (1-year: 54.5% vs. 53.5%; 3-year: 30.5% vs. 28.7%; 5-year: 14.2% vs. 14.9%; P=0.873). WO and HIO groups did not differ in 30-day, 90-day mortality and rate of postoperative complications (all P>0.05).


CONCLUSIONS
Our data indicates that HIO might not negatively affect the OS and DFS of HCC patients undergoing liver resection and is likely to be a safe and viable option for intraoperative blood loss control.
Department of Hepatobiliary Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China.|Department of General Surgery, Second People's Hospital of Jingmen, Jingmen, China.
Jing-Hang
JH
Jiang
Department of Obstetrics and Gynecology, Second People's Hospital of Jingmen, Jingmen, China.
Kai-Xiu
KX
Wang
Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Ji-Ye
JY
Zhu
Department of General Surgery, Second People's Hospital of Jingmen, Jingmen, China.
Pei-Pei
PP
Yang
Department of Thyroid and Breast Surgery, Wuhan Central Hospital, Wuhan, China.
Zhe
Z
Guo
Department of General Surgery, Second People's Hospital of Jingmen, Jingmen, China.
Song-Lin
SL
Ma
Department of General Surgery, Second People's Hospital of Jingmen, Jingmen, China.
Yang
Y
Lü
Department of Hepatobiliary Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China - 474522490@qq.com.
Bang-De
BD
Xiang
Department of Hepatobiliary Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China.
Jian-Hong
JH
Zhong
Department of Hepatobiliary Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China.
Le-Qun
LQ
Li
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome