Annals of Surgical Oncology

, Volume 22, Issue 7, pp 2253–2261 | Cite as

Impact of Steatosis on Prognosis of Patients with Early-Stage Hepatocellular Carcinoma After Hepatic Resection

  • Chien-Wei Su
  • Gar-Yang Chau
  • Hung-Hsu Hung
  • Yi-Chen Yeh
  • Hao-Jan Lei
  • Cheng-Yuan Hsia
  • Chiung-Ru Lai
  • Han-Chieh Lin
  • Jaw-Ching Wu
Hepatobiliary Tumors



It is still unclear whether steatosis determines the prognosis of patients with hepatocellular carcinoma (HCC). This study aimed to compare the clinical manifestations and outcomes between early-stage HCC patients with and without steatosis after hepatic resection.


We enrolled 188 patients who underwent hepatic resection for HCC within the Milan criteria. After surgery, fibrosis, steatosis, lobular inflammation, portal inflammation, and ballooning in the background liver were assessed. Factors related to prognosis after surgery were analyzed by multivariate analysis.


Seventy-four patients (39.4 %) had steatosis. Patients with steatosis had larger body mass index, higher fasting glucose levels, and higher rates of ballooning than those without steatosis. After a median follow-up period of 69.8 months, 73 patients died. The cumulative survival rates at 5 years were 57.8 and 75.6 % for patients with and without steatosis, respectively (p = 0.008). Multivariate analysis disclosed that an age of > 65 years [hazard ratio (HR) 1.996, p = 0.009], platelet count of <105/mm3 (HR 2.198, p = 0.005), indocyanine green retention rate at 15 min of >10 % (HR 2.037, p = 0.022), multinodularity (HR 2.389, p = 0.004), and steatosis (HR 1.773, p = 0.023) were independent risk factors associated with poor overall survival after resection. The impact of steatosis on postsurgical prognosis was more apparent in patients without cirrhosis.


The presence of steatosis in the background liver was associated with a poor prognosis in early-stage HCC patients after hepatic resection, especially for noncirrhotic patients.


Hepatic Resection Milan Criterion Background Liver Lobular Inflammation Portal Inflammation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by grants from the National Science Council of Taiwan (NSC 101-2314-B-075-013-MY2), Taipei Veterans General Hospital (V102C-117, C103C-055, VGHUST100-G7-2-1), Yang-Ming University (101AC-T501, Ministry of Education, Aim for the Top University Plan), and the Center of Excellence for Cancer Research at TVGH (DOH102-TD-C-111-007), Taipei, Taiwan.


The authors declare no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 41 kb)


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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Chien-Wei Su
    • 1
    • 2
  • Gar-Yang Chau
    • 2
    • 3
  • Hung-Hsu Hung
    • 2
    • 4
    • 5
  • Yi-Chen Yeh
    • 2
    • 4
    • 6
  • Hao-Jan Lei
    • 2
    • 3
  • Cheng-Yuan Hsia
    • 2
    • 3
  • Chiung-Ru Lai
    • 2
    • 6
  • Han-Chieh Lin
    • 1
    • 2
  • Jaw-Ching Wu
    • 4
    • 7
  1. 1.Division of Gastroenterology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
  2. 2.Faculty of Medicine, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Division of General Surgery, Department of SurgeryTaipei Veterans General HospitalTaipeiTaiwan
  4. 4.Institute of Clinical Medicine, School of Medicine and Cancer Research CenterNational Yang-Ming UniversityTaipeiTaiwan
  5. 5.Division of Gastroenterology, Department of MedicineCheng Hsin General HospitalTaipeiTaiwan
  6. 6.Department of Pathology and Laboratory MedicineTaipei Veterans General HospitalTaipeiTaiwan
  7. 7.Division of Translational Research, Department of Medical ResearchTaipei Veterans General HospitalTaipeiTaiwan

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