Bekki Tomoaki, Abe Tomoyuki, Amano Hironobu, Hattori Minoru, Kobayashi Tsuyoshi, Nakahara Masahiro, Ohdan Hideki, Noriyuki Toshio
Department of Surgery, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan.
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima, Japan.
BMC Gastroenterol. 2020 Oct 7;20(1):328. doi: 10.1186/s12876-020-01472-z.
This study aimed to assess the prognostic factors including low skeletal muscle mass index (SMI) and perioperative blood transfusion for patients with hepatocellular carcinoma (HCC) following curative surgery.
This study included 139 patients with HCC who underwent hepatectomy between 2005 and 2016. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS) and recurrence-free survival (RFS).
Low SMI was significantly related with poor OS, while blood transfusion had a strong impact on RFS. The male ratio and body mass index in the low SMI group were significantly higher than those in the high SMI group. There were no significant differences in age, virus etiology, laboratory data, liver function, tumor makers, and operative variables between the groups. Tumor factors such as tumor diameter, tumor number, poor differentiation, and intrahepatic metastasis (IM) did not significantly differ between the two groups. Operation time, intraoperative blood loss volume, and recurrence ratio were significantly higher in the blood transfusion group than in the non-transfusion group. IM was associated with poor OS and RFS.
Low SMI and blood transfusion were independently related with long-term prognosis in patients with HCC following curative surgery.
本研究旨在评估肝细胞癌（HCC）根治性手术后患者的预后因素，包括低骨骼肌质量指数（SMI）和围手术期输血情况。
本研究纳入了2005年至2016年间接受肝切除术的139例HCC患者。进行单因素和多因素分析以确定与总生存期（OS）和无复发生存期（RFS）相关的变量。
低SMI与较差的OS显著相关，而输血对RFS有强烈影响。低SMI组的男性比例和体重指数显著高于高SMI组。两组在年龄、病毒病因、实验室数据、肝功能、肿瘤标志物和手术变量方面无显著差异。两组之间的肿瘤直径、肿瘤数量、低分化和肝内转移（IM）等肿瘤因素无显著差异。输血组的手术时间、术中失血量和复发率显著高于非输血组。IM与较差的OS和RFS相关。
低SMI和输血与HCC根治性手术后患者的长期预后独立相关。
