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Intraoperative portal venous pressure and long-term outcome after curative resection for hepatocellular carcinoma


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Title: Intraoperative portal venous pressure and long-term outcome after curative resection for hepatocellular carcinoma
Authors: Hidaka, Masaaki / Takatsuki, Mitsuhisa / Soyama, Akihiko / Tanaka, Takayuki / Muraoka, Izumi / Hara, Takanobu / Kuroki, Tamotsu / Kanematsu, Takashi / Eguchi, Susumu
Issue Date: Sep-2012
Publisher: John Wiley and Sons Ltd
Citation: British Journal of Surgery, 99(9), pp.1284-1289; 2012
Abstract: Background: Outcomes of liver resection for hepatocellular carcinoma (HCC) have improved owing to better surgical techniques and patient selection. Portal hypertension may influence outcome but the preoperative definition and role of portal hypertension are far from clear. The aim of this study was to elucidate the influence of portal venous pressure (PVP) measured directly during surgery on outcomes of liver resection in patients with HCC. Methods: Patients who had resection of HCC between 1997 and 2009, and who underwent direct measurement of PVP immediately after laparotomy were enrolled. These patients were divided into groups with high (at least 20 cmH 2O) and low (less than 20 cmH 2O) PVP. The influence of PVP on overall and recurrence-free survival was analysed and prognostic factors were identified. Results: A total of 177 patients were enrolled, 129 in the low-PVP group and 48 in the high-PVP group. The 5-year overall survival rate (63·7 versus 31 per cent; P < 0·001) and recurrence-free survival rate (52·5 versus 12 per cent; P < 0·001) were significantly higher in patients with low PVP. In multivariable analysis, two or more tumours, tumour diameter at least 5 cm, high PVP, grade B liver damage and Hepatic Activity Index (HAI) grade 7 or more were significant predictors of poorer survival after liver resection. Two or more tumours, tumour diameter at least 5 cm and HAI grade 7 or more were significant predictors of poorer recurrence-free survival. Conclusion: High PVP was associated with poor long-term outcome after liver resection for HCC.
Keywords: hepatocellular carcinoma / liver resection / portal venous pressure
URI: http://hdl.handle.net/10069/33453
ISSN: 00071323
DOI: 10.1002/bjs.8861
Rights: © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. / This is the pre-peer reviewed version of the following article: British Journal of Surgery, 99(9), pp.1284-1289; 2012, which has been published in final form at http://dx.doi.org/10.1002/bjs.8861
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/33453

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