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

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgment

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.

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Chien-Wei Su MD, PhD & Han-Chieh Lin MD

  2. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Chien-Wei Su MD, PhD, Gar-Yang Chau MD, MPH, Hung-Hsu Hung MD, Yi-Chen Yeh MD, Hao-Jan Lei MD, Cheng-Yuan Hsia MD, Chiung-Ru Lai MD & Han-Chieh Lin MD

  3. Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    Gar-Yang Chau MD, MPH, Hao-Jan Lei MD & Cheng-Yuan Hsia MD

  4. Institute of Clinical Medicine, School of Medicine and Cancer Research Center, National Yang-Ming University, Taipei, Taiwan

    Hung-Hsu Hung MD, Yi-Chen Yeh MD & Jaw-Ching Wu MD, PhD

  5. Division of Gastroenterology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan

    Hung-Hsu Hung MD

  6. Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Yi-Chen Yeh MD & Chiung-Ru Lai MD

  7. Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan

    Jaw-Ching Wu MD, PhD

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  1. Chien-Wei Su MD, PhD
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  2. Gar-Yang Chau MD, MPH
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  9. Jaw-Ching Wu MD, PhD
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Corresponding authors

Correspondence to Gar-Yang Chau MD, MPH or Jaw-Ching Wu MD, PhD.

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Su, CW., Chau, GY., Hung, HH. et al. Impact of Steatosis on Prognosis of Patients with Early-Stage Hepatocellular Carcinoma After Hepatic Resection. Ann Surg Oncol 22, 2253–2261 (2015). https://doi.org/10.1245/s10434-014-4221-5

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  • DOI: https://doi.org/10.1245/s10434-014-4221-5

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