Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Jan 11;15(1):1724.
doi: 10.1038/s41598-024-85020-9.

Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study

Shiye Yang #  1 , Haishun Ni #  2 , Aixian Zhang #  3 , Jixiang Zhang #  4 , Hong Zang  5   6 , Zhibing Ming  7   7
Affiliations
Observational Study

Impact of postoperative morbidity on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: a multicenter observational study

Shiye Yang et al. Sci Rep. .

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.

Keywords: Hepatocellular carcinoma; Laparoscopic liver resection; Morbidity; Recurrence; Survival.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Consent to participate: This study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Ethical approval was obtained from the Institutional Ethics Committee of Nantong First People’s Hospital (approval number: 2024KT260). Due to the retrospective nature of the study, the Institutional Ethics Committee of Nantong First People’s Hospital waived the need of obtaining informed consent. Consent to publish: All authors confirm that the work described has not been published before and is not under consideration for publication elsewhere. All authors have seen and gave consent to the publication of this study. Ethics approval: Ethical approval was obtained from the Institutional Ethics Committee of Nantong First People’s Hospital (approval number: 2024KT260). Due to the retrospective nature of the study, the Institutional Ethics Committee of Nantong First People’s Hospital waived the need of obtaining informed consent.

Figures

Fig. 1
Fig. 1
The flow chart of this study. Abbreviation: HCC, hepatocellular carcinoma; TACE, transcatheter arterial chemoembolization; ICC, intrahepatic cholangiocarcinoma; ICC-HCC, intrahepatic cholangiocarcinoma-hepatocellular carcinoma.
Fig. 2
Fig. 2
Cumulative incidence of overall survival (A) and recurrence (B) curves comparisons and early recurrence (≤ 2 years after surgery) (C) and late recurrence (> 2 years after surgery) (D) curves comparisons between patients with and without postoperative 30-day morbidity.
See this image and copyright information in PMC

References

    1. Villanueva, A. Hepatocellular carcinoma N Engl. J. Med.380(15), 1450–1462. (2019). - DOI - PubMed
    1. Jarnagin, W. R. et al. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann. Surg.236(4), 397–406 (2002). discussion – 7. - DOI - PMC - PubMed
    1. Kusano, T. et al. Predictors and prognostic significance of operative complications in patients with hepatocellular carcinoma who underwent hepatic resection. Eur. J. Surg. Oncol.35(11), 1179–1185 (2009). - DOI - PubMed
    1. Huang, Z. Q. et al. Hepatic resection: an analysis of the impact of operative and perioperative factors on morbidity and mortality rates in 2008 consecutive hepatectomy cases. Chin. Med. J. (Engl). 122(19), 2268–2277 (2009). - PubMed
    1. Wei, A. C., Tung-Ping Poon, R., Fan, S. T. & Wong, J. Risk factors for perioperative morbidity and mortality after extended hepatectomy for hepatocellular carcinoma. Br. J. Surg.90(1), 33–41 (2003). - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources