Utsunomiya Tohru, Okamoto Masahiro, Kameyama Toshihumi, Matsuyama Ayumi, Yamamoto Manabu, Fujiwara Megumu, Mori Masaki, Aimitsu Shiomi, Ishida Teruyoshi
Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan.
World J Gastroenterol. 2008 Mar 14;14(10):1553-8. doi: 10.3748/wjg.14.1553.
To evaluate the impact of obesity on the posto-perative outcome after hepatic resection in patients with hepatocellular carcinoma (HCC).
Data from 328 consecutive patients with primary HCC and 60 patients with recurrent HCC were studied. We compared the surgical outcomes between the non-obese group (body mass index: BMI < 25 kg/m(2)) and the obese group (BMI > or = 25 kg/m(2)).
Following curative hepatectomy in patients with primary HCC, the incidence of postoperative complications and the long-term prognosis in the non-obese group (n = 240) were comparable to those in the obese group (n = 88). Among patients with recurrent HCC, the incidence of postoperative complications after repeat hepatectomy was not significantly different between the non-obese group (n = 44) and the obese group (n = 16). However, patients in the obese group showed a significantly poorer long-term prognosis than those in the non-obese group (P < 0.05, five-year survival rate; 51.9% and 92.0%, respectively).
Obesity alone may not have an adverse effect on the surgical outcomes of patients with primary HCC. However, greater caution seems to be required when planning a repeat hepatectomy for obese patients with recurrent HCC.
评估肥胖对肝细胞癌（HCC）患者肝切除术后结局的影响。
研究了328例连续性原发性HCC患者和60例复发性HCC患者的数据。我们比较了非肥胖组（体重指数：BMI < 25 kg/m²）和肥胖组（BMI ≥ 25 kg/m²）之间的手术结局。
原发性HCC患者行根治性肝切除术后，非肥胖组（n = 240）的术后并发症发生率和长期预后与肥胖组（n = 88）相当。在复发性HCC患者中，非肥胖组（n = 44）和肥胖组（n = 16）再次肝切除术后的术后并发症发生率无显著差异。然而，肥胖组患者的长期预后明显比非肥胖组差（P < 0.05，五年生存率分别为51.9%和92.0%）。
单纯肥胖可能不会对原发性HCC患者的手术结局产生不利影响。然而，对于复发性HCC的肥胖患者计划再次肝切除时似乎需要更加谨慎。
