RISK-FACTORS LINKED TO POSTOPERATIVE MORBIDITY IN PATIENTS WITH HEPATOCELLULAR-CARCINOMA

Background The aim of this study was to clarify the risk factors for m orbidity as well as to establish an optimum surgical strategy for hepa tocellular carcinoma (HCC). Methods The risk factors linked to postope rative complications were analysed in 388 patients over a 10-year peri od, according to the kind of operative procedure. Results Stepwise reg ression analysis revealed that the most important factors related to p ostoperative morbidity were: age, creatinine level and the histologica l grade of fibrosis for the bisegmentectomy; the presence of diabetes mellitus, blood urea nitrogen level, the indocyanine green dye retenti on rate at 15 min and blood loss for the segmentectomy; the presence o f diabetes mellitus and blood loss for subsegmentectomy; the presence of diabetes mellitus, the aspartate aminotransferase level, and the to tal operating time for resection less than subsegmentectomy. Conclusio n The most important risk factors were not always related to liver fun ction tests, but instead to other coexisting conditions such as diabet es mellitus and operation stress including operating time and blood lo ss. Therefore, any future treatment strategy of hepatic resection for HCC should make every effort both to evaluate coexisting conditions ca refully and to reduce operative stress as far as possible.