Perioperative non-tumorous factors associated with survival in HCC patients who underwent hepatectomy.

AIM To clarify perioperative factors associated with poor survival following hepatectomy. PATIENTS AND METHODS Clinical parameters and stress score, including surgical stress score (SSS) and comprehensive risk score (CRS) were examined from 183 hepatocellular carcinoma patients who underwent hepatectomy. RESULTS Factors associated with tumor relapse were increased blood loss/weight, uncontrolled ascites and grade B liver damage (p<0.05). Ascites was identified as an independent risk factor by multivariate logistic regression analysis. Increased blood loss/weight, transfusion, high SSS, high CRS, ascites, and grade B liver damage were associated with poor disease-free survival (p<0.05). Increased blood loss/weight, transfusion, ascites, and grade B liver damage were associated with poor overall survival (p<0.05), and ascites, transfusion, male sex and grade B liver damage were identified as independent risk factors. CONCLUSION Reducing blood loss and avoiding transfusion appear important for improving prognosis. Maintenance of liver function is necessary in cases showing poor liver function and uncontrolled ascites.