Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study
Abstract The long-term impact of postoperative morbidity following laparoscopic liver resection for hepatocellular carcinoma is unclear. This study aimed to investigate whether the prognosis of hepatocellular carcinoma patients were affected by postoperative morbidity after laparoscopic liver resect...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-85020-9 |
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| author | Shiye Yang Haishun Ni Aixian Zhang Jixiang Zhang Hong Zang Zhibing Ming |
| author_facet | Shiye Yang Haishun Ni Aixian Zhang Jixiang Zhang Hong Zang Zhibing Ming |
| author_sort | Shiye Yang |
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| description | Abstract The long-term impact of postoperative morbidity following laparoscopic liver resection for hepatocellular carcinoma is unclear. This study aimed to investigate whether the prognosis of hepatocellular carcinoma patients were affected by postoperative morbidity after laparoscopic liver resection. Hepatocellular carcinoma patients who underwent curative-intent laparoscopic liver resection were included. Risk factors of 30-day morbidity were identified using logistic regression analysis. Early (≤ 2 years) and late (> 2 years) recurrence rates, overall survival, and time to recurrence were compared among patients with and without postoperative morbidity. Independent prognostic factors of overall survival and time to recurrence of these patients were investigated using Cox regression analysis. This study included 420 patients, 147 (35%) of whom experienced postoperative morbidity. Diabetes mellitus, cirrhosis, portal hypertension, Child-Pugh grade B, multiple tumors, poor tumor differentiation and intraoperative blood transfusion were risk factors of postoperative morbidity. Patients with postoperative morbidity had higher early and late recurrence rates than those without postoperative morbidity (38.8% vs. 22.4%, P = 0.001; 50% vs. 25.5%, P = 0.001). Postoperative morbidity was associated with decreased overall survival (median: 54.5 months vs. not reached, P < 0.001) and time to recurrence (median: 36.4 vs. 68.2 months; P < 0.001). Postoperative morbidity resulted in a 43% and 92% higher risk of long-term mortality (HR 1.43; 95% CI 1–2.03; P = 0.048) and recurrence (HR 1.92; 95% CI 1.41–2.62; P < 0.001). For hepatocellular carcinoma patients undergoing laparoscopic liver resection, long-term oncologic outcomes are adversely affected by postoperative morbidity. Therefore, it is of great importance for surgeons to prevent and manage postoperative morbidity. |
| format | Article |
| id | doaj-art-5b2071c0b9a64d2095517c3e329e632d |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-5b2071c0b9a64d2095517c3e329e632d2025-01-12T12:23:41ZengNature PortfolioScientific Reports2045-23222025-01-0115111110.1038/s41598-024-85020-9Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational studyShiye Yang0Haishun Ni1Aixian Zhang2Jixiang Zhang3Hong Zang4Zhibing Ming5Department of Comprehensive Surgery, Vascular Surgery, Nantong First People’s Hospital, Affiliated Hospital 2 of Nantong UniversityDepartment of General Surgery, Nantong Second People’s HospitalDepartment of Hepato-Biliary-Pancreatic Surgery, Chinese People’s Liberation Army (PLA) General HospitalDepartment of Hepatobiliary Surgery, Zhongshan People’s HospitalDepartment of Comprehensive Surgery, Hepato-Biliary-Pancreatic Surgery, Nantong First People’s Hospital, Affiliated Hospital 2 of Nantong UniversityDepartment of Comprehensive Surgery, Vascular Surgery, Nantong First People’s Hospital, Affiliated Hospital 2 of Nantong UniversityAbstract The long-term impact of postoperative morbidity following laparoscopic liver resection for hepatocellular carcinoma is unclear. This study aimed to investigate whether the prognosis of hepatocellular carcinoma patients were affected by postoperative morbidity after laparoscopic liver resection. Hepatocellular carcinoma patients who underwent curative-intent laparoscopic liver resection were included. Risk factors of 30-day morbidity were identified using logistic regression analysis. Early (≤ 2 years) and late (> 2 years) recurrence rates, overall survival, and time to recurrence were compared among patients with and without postoperative morbidity. Independent prognostic factors of overall survival and time to recurrence of these patients were investigated using Cox regression analysis. This study included 420 patients, 147 (35%) of whom experienced postoperative morbidity. Diabetes mellitus, cirrhosis, portal hypertension, Child-Pugh grade B, multiple tumors, poor tumor differentiation and intraoperative blood transfusion were risk factors of postoperative morbidity. Patients with postoperative morbidity had higher early and late recurrence rates than those without postoperative morbidity (38.8% vs. 22.4%, P = 0.001; 50% vs. 25.5%, P = 0.001). Postoperative morbidity was associated with decreased overall survival (median: 54.5 months vs. not reached, P < 0.001) and time to recurrence (median: 36.4 vs. 68.2 months; P < 0.001). Postoperative morbidity resulted in a 43% and 92% higher risk of long-term mortality (HR 1.43; 95% CI 1–2.03; P = 0.048) and recurrence (HR 1.92; 95% CI 1.41–2.62; P < 0.001). For hepatocellular carcinoma patients undergoing laparoscopic liver resection, long-term oncologic outcomes are adversely affected by postoperative morbidity. Therefore, it is of great importance for surgeons to prevent and manage postoperative morbidity.https://doi.org/10.1038/s41598-024-85020-9Hepatocellular carcinomaLaparoscopic liver resectionMorbiditySurvivalRecurrence |
| spellingShingle | Shiye Yang Haishun Ni Aixian Zhang Jixiang Zhang Hong Zang Zhibing Ming Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study Scientific Reports Hepatocellular carcinoma Laparoscopic liver resection Morbidity Survival Recurrence |
| title | Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study |
| title_full | Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study |
| title_fullStr | Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study |
| title_full_unstemmed | Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study |
| title_short | Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study |
| title_sort | impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection a multicenter observational study |
| topic | Hepatocellular carcinoma Laparoscopic liver resection Morbidity Survival Recurrence |
| url | https://doi.org/10.1038/s41598-024-85020-9 |
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