Pre‐operative predictors of early recurrence/mortality including the role of inflammatory indices in patients undergoing partial hepatectomy for spontaneously ruptured hepatocellular carcinoma. Issue 8 (6th November 2018)

• Record Type: Journal Article
• Authors: Chua, Darren W; KOH, Ye Xin; LIEW, Yi Xin; Chan, Chung‐Yip; Lee, Ser‐Yee; Cheow, Peng‐Chung; Chow, Pierce K; Chung, Alexander Y; Ooi, London L; Goh, Brian KP
• Is Part Of: Journal of surgical oncology. Volume 118:Issue 8(2018)
• Page Start: 1227
• Page End: 1236
• Publication Date: 2018-11-06
• Subjects: futile -- inflammatory indices -- prognosis -- ruptured hepatocellular carcinoma -- surgery; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25281
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract : Background and Objectives: Spontaneous rupture of Hepatocellular Carcinoma (srHCC) is a life‐threatening emergency. We sought to identify the pre‐operative predictors of early tumor recurrence/mortality including the role of inflammatory indices after partial hepatectomy for srHCC. Methods: Between 2000‐2015, 79 patients with srHCC were identified to have undergone upfront partial hepatectomy following srHCC. Clinicopathologic data were retrospectively analyzed to identify pre‐operative predictors of early (<1 year) recurrence and mortality. Results: Seventy‐nine patients were identified to have undergone partial hepatectomy for srHCC. The 1‐year mortality and 1‐year recurrence rate in our series was 30.3% and 41.8% respectively. On multivariate analyses, free tumor rupture and a tumor size > 10 cm were identified to be independent predictors of early recurrence while an alpha fetoprotein (AFP) > 200 ng/mL was an independent predictor of early mortality. Neutrophil‐to‐lymphocyte ratio > 3 and prognostic nutritional index < 40 were predictors of early recurrence while PLR > 180 was a predictor of early mortality on univariate analyses but not multivariate analyses. Conclusions: Tumor size > 10 cm, free tumor rupture, and an AFP > 200 ng/mL were useful predictors in avoiding "futile surgery" in patients with srHCC undergoing a partial hepatectomy. Preoperative inflammatory markers appear to be less useful as predictors of early recurrence/mortality in this cohort of patients.