Preditive factors of postoperative mortality after hepatic resection for hepatocellular carcinoma - Retrospective study of 69 cases

  • B. Pinto Costa Assistente Hospitalar do Serviço de Cirurgia III dos Hospitais da Universidade de Coimbra – E.P.E.; Assistente Convidada da Clínica Universitária de Cirurgia III da Faculdade de Medicina da Universidade de Coimbra. Portugal
  • F. Castro Sousa Professor Catedrático de Cirurgia da Faculdade de Medicina da Universidade de Coimbra e Director da Clínica Universitária de Cirurgia III; Director do Departamento de Cirurgia e do Serviço de Cirurgia III dos Hospitais da Universidade de Coimbra – E.P.E. Portugal
  • M. Serôdio Interno de Cirurgia Geral do Serviço de Cirurgia III dos Hospitais da Universidade de Coimbra – E.P.E. Portugal
  • C. Carvalho Interno de Cirurgia Geral do Serviço de Cirurgia III dos Hospitais da Universidade de Coimbra – E.P.E. Portugal

Abstract

Recently, mortality associated with hepatic resection suffered a considerably reduction. To determine the prognostic factors of mortality after hepatic resection for hepatocellular carcinoma, a retrospective study of 69 cases operated between 1990 and 2008 was undertaken. Patients ́ mean age was 61,8 years-old and 93% were male. Chronic liver disease was present in 73% of cases. Mean Charlson’s Index and M.E.L.D. were 4,5 and 9,7, respectively. Fifty percent of the tumors were in stage I of T.N.M. classification, 27% in II and 23% in III. Thirty three resections were major (48%) and nine iterative (13%). Mortality and morbidity rates were 7,2% and 47,8%, respectively. In univariate analysis, mortality was significantly related with age (72,6±6,9 vs 60,9±10,9; p=0,022), Béclére Index,T.N.M. and Okuda staging systems. The other analyzed variables weren’t statistically relevant, including Charlson’s Index, M.E.L.D., hepatic fibrosis and steatosis, type of operation (major or minor, iterative or primary), transfusions, Pringle maneuver and others. Patients with age equal or superior to 70 years-old had higher mortality rates (21,1 vs 2%; p=0,006; odds ratio=10,5; accuracy=77%) and age revealed to be the only independent predictive factor in multivariate analysis. The probability of operative death increase with age between 0,05% (≤ 50 years old), 2,9% (51-69) and 20,2% (≥ 70). The present series suggests that age represent a relevant factor in preoperative evaluation of patients candidate to hepatic resection for hepatocellular carcinoma.

Keywords: Postoperative mortality, hepatic resection, hepatocellular carcinoma 

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Published
2009-12-27
How to Cite
COSTA, B. Pinto et al. Preditive factors of postoperative mortality after hepatic resection for hepatocellular carcinoma - Retrospective study of 69 cases. Revista Portuguesa de Cirurgia, [S.l.], n. 11, p. 33-44, dec. 2009. ISSN 2183-1165. Available at: <https://revista.spcir.com/index.php/spcir/article/view/182>. Date accessed: 24 apr. 2024.
Section
Original Papers