Intraoperative portal venous pressure and long-term outcome after curative resection for hepatocellular carcinoma
British Journal of Surgery, 08/08/2012
Hidaka M et al. – High portal venous pressure (PVP) was associated with poor long–term outcome after liver resection for hepatocellular carcinoma (HCC).Methods
- Patients who had resection of HCC between 1997 and 2009, and who underwent direct measurement of PVP immediately after laparotomy were enrolled.
- These patients were divided into groups with high (at least 20 cmH2O) and low (less than 20 cmH2O) PVP.
- The influence of PVP on overall and recurrence–free survival was analysed and prognostic factors were identified.
- A total of 177 patients were enrolled, 129 in the low–PVP group and 48 in the high–PVP group.
- The 5–year overall survival rate (63•7 versus 31 per cent; P < 0•001) and recurrence–free survival rate (52•5 versus 12 per cent; P < 0•001) were significantly higher in patients with low PVP.
- In multivariable analysis, two or more tumours, tumour diameter at least 5 cm, high PVP, grade B liver damage and Hepatic Activity Index (HAI) grade 7 or more were significant predictors of poorer survival after liver resection.
- Two or more tumours, tumour diameter at least 5 cm and HAI grade 7 or more were significant predictors of poorer recurrence–free survival.