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World J Gastroenterol. Mar 14, 2008; 14(10): 1553-1558
Published online Mar 14, 2008. doi: 10.3748/wjg.14.1553
Impact of obesity on the surgical outcome following repeat hepatic resection in Japanese patients with recurrent hepatocellular carcinoma
Tohru Utsunomiya, Masahiro Okamoto, Toshihumi Kameyama, Ayumi Matsuyama, Manabu Yamamoto, Megumu Fujiwara, Masaki Mori, Shiomi Aimitsu, Teruyoshi Ishida
Tohru Utsunomiya, Masahiro Okamoto, Toshihumi Kameyama, Ayumi Matsuyama, Manabu Yamamoto, Teruyoshi Ishida, Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan
Megumu Fujiwara, Department of Pathology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan
Masaki Mori, Department of Radiology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan
Shiomi Aimitsu, Department of Internal Medicine of the Liver, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan
Author contributions: Utsunomiya T designed the research; Utsunomiya T, Okamoto M, Kameyama T, Matsuyama A, Yamamoto M, Fujiwara M, Mori M, Aimitsu S, and Ishida T performed the research; Utsunomiya T analyzed the data and wrote the paper.
Correspondence to: Dr. Tohru Utsunomiya, Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan. tohru@hiroshima-med.jrc.or.jp
Telephone: +81-82-2413111
Fax: +81-82-2460676
Received: September 13, 2007
Revised: November 22, 2007
Published online: March 14, 2008
Abstract

AIM: To evaluate the impact of obesity on the posto-perative outcome after hepatic resection in patients with hepatocellular carcinoma (HCC).

METHODS: Data from 328 consecutive patients with primary HCC and 60 patients with recurrent HCC were studied. We compared the surgical outcomes between the non-obese group (body mass index: BMI < 25 kg/m2) and the obese group (BMI ≥ 25 kg/m2).

RESULTS: Following curative hepatectomy in patients with primary HCC, the incidence of postoperative complications and the long-term prognosis in the non-obese group (n = 240) were comparable to those in the obese group (n = 88). Among patients with recurrent HCC, the incidence of postoperative complications after repeat hepatectomy was not significantly different between the non-obese group (n = 44) and the obese group (n = 16). However, patients in the obese group showed a significantly poorer long-term prognosis than those in the non-obese group (P < 0.05, five-year survival rate; 51.9% and 92.0%, respectively).

CONCLUSION: Obesity alone may not have an adverse effect on the surgical outcomes of patients with primary HCC. However, greater caution seems to be required when planning a repeat hepatectomy for obese patients with recurrent HCC.

Keywords: Body mass index, Hepatocellular carcinoma, Hepatectomy, Prognosis