Clinical outcome of cardiac surgery in patients with remitted or active hepatocellular carcinoma



Hepatocellular carcinoma (HCC) is one of the most common primary cancers worldwide. HCC has unique characteristics such as co-existing chronic liver damage and a high recurrence rate. A negative impact on the surgical outcome due to these backgrounds could be expected. We aimed to evaluate the clinical outcomes of cardiac surgery in these patients.


Between January 2000 and December 2019, 16 patients with remitted cancer and 5 patients with active HCC who underwent open heart surgery were studied. The clinical data were retrospectively evaluated from hospital records. Follow-up information was collected via telephone interviews.


The major cause of HCC was viral hepatitis. Eighteen patients (86%) were classified as having Child–Pugh class A cirrhosis. The mean model of end-stage liver disease (MELD) score was 7.2 ± 5.2. There was no 30-day mortality. During follow-up, 11 patients died due to HCC. The 1-, 3-, and 5-year survival rates were 80.0, 42.5, and 22.3%, respectively. A univariate analysis identified a higher preoperative MELD score and lower serum cholinesterase levels as prognostic factors for long-term survival.


We could safely perform cardiac surgery in selected patients with remitted and active HCC. The postoperative life expectancy of these patients was limited but acceptable.

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This study was not supported by any funding.

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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by KT, KA, TT, HO, TS, YS, TK, YZ, SK, KS, and AO. This study was supervised by ET. The first draft of the manuscript was written by KT, and all authors commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Kazuyoshi Takagi.

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Takagi, K., Arinaga, K., Takaseya, T. et al. Clinical outcome of cardiac surgery in patients with remitted or active hepatocellular carcinoma. Surg Today (2021).

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  • Hepatocellular carcinoma
  • Liver cirrhosis
  • Cardiac surgery
  • Outcome