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Oct.  2014
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Article Navigation >  Journal of Clinical Hepatology  > 2014  >  30(10): 1009-1014

Meta-analysis of risk factors for posthepatectomy liver failure in patients with hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2014.10.009

  • Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University

  • Received Date: 2014-05-14
  • Published Date: 2014-10-20
    Abstract

  • Objective To investigate the risk factors for posthepatectomy liver failure ( PHLF) in patients with hepatocellular carcinoma ( HCC) and to provide a theoretical basis for the prediction and prevention of PHLF. Methods A meta-analysis was performed on the studies on risk factors for PHLF in HCC patients published in China from January 1990 to June 2013 by searching SinoMed, VIP, CNKI, and Wanfang Data and manual retrieval of related articles and references. Results A total of 11 studies involving 2859 patients treated with hepatectomy were included in the meta-analysis. The incidence of PHLF was significantly lower in Child-Pugh A patients than in the control group ( pooled OR = 6. 28, 95% CI: 4. 55-8. 65) . Patients with prealbumin levels less than 170 mg /dl had an increased incidence of PHLF ( pooled OR = 4. 96, 95% CI: 3. 03-8. 10) . Patients with cirrhosis had a higher incidence of PHLF than those without cirrhosis ( pooled OR = 4.14, 95%CI: 2.46-6.98) . Patients with an intraoperative blood loss less than 1000 ml had a lower incidence of PHLF than the control group ( pooled OR = 5. 62, 95% CI: 3. 46-9. 11) . The incidence of PHLF was lower in patients with a tumor diameter less than 10 cm and patients with an extent of resection less than hepatectomy than in the control group ( pooled OR = 2. 69, 95% CI: 1. 58-4. 57; pooled OR = 1. 64, 95% CI: 1. 12-2. 40) . Age ≥60 years and intraoperative blood transfusion increased the incidence of PHLF ( pooled OR = 1.73, 95% CI: 1.25-2.39; pooled OR = 3.79, 95% CI: 2.20-6.51) . Sex and hepatic inflow occlusion were not significantly associated with the development of PHLF ( P > 0. 05) Conclusion Advanced age, advanced preoperative Child-Pugh class, low prealbumin level, high intraoperative blood loss, large tumor diameter, large extent of hepatectomy, cirrhosis, and intraoperative blood transfusion are risk factors for the development of PHLF.

     

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  • [1]van DEN BROEK MA, OLDE DAMINK SW, DEJONG CH, et al.Liver failure after partial hepatic resection:definition, pathophysiology, risk factors and treatment[J].Liver Int, 2008, 28 (6) :767-780.
    [2]WANG SG, MA CL, LU Y, et al.Risk factor analysis and treatment for hepatic failure after hepatectomy for primary liver cancer[J].Shanxi J Med, 2007, 36 (6) :691-693. (in Chinese) 王守光, 马长林, 卢云, 等.原发性肝癌肝切除术后肝功能衰竭的相关因素分析及防治[J].陕西医学杂志, 2007, 36 (6) :691-693.
    [3]CHEN GH.Clinical analysis of hepatic failure after hepatectomy for primary liver cancer[D].Zhejiang:Zhejiang University College of Medicine, 2008. (in Chinese) 陈刚红.原发性肝癌术后肝功能衰竭的临床因素分析[D].浙江:浙江大学医学院, 2008.
    [4]CHEN XT, ZHAI J, ZHANG YJ, et al.The risk factors of posthepatectomy liver failure for hepatocellular carcinoma in patients of Child-Pugh A[J].J Hepatobiliary Surg, 2012, 20 (3) :170-173. (in Chinese) 陈绪涛, 翟健, 张一军, 等.Child-Pugh A级肝细胞癌患者术后肝功能衰竭发生的危险因素分析[J].肝胆外科杂志, 2012, 20 (3) :170-173.
    [5]HU SQ, HE J, YU Y, et al.Influence factors for acute liver failure after hepatectomy of primary hepatic carcinoma[J].J Guangxi Coll Tradit Chin Med, 2010, 13 (3) :8-10. (in Chinese) 胡嗣钦, 赫军, 俞渊, 等.原发性肝癌术后急性肝功能衰竭影响因素分析[J].广西中医学院学报, 2010, 13 (3) :8-10.
    [6]SUN ZD, JIANG Y, ZHU F, et al.Clinical analysis of hepatic failure after hepatectomy for liver cancer associated with cirrhosis[J].J Hepatopancreatobiliary Surg, 2010, 22 (6) :463-465. (in Chinese) 孙振棣, 江勇, 朱峰, 等.原发性肝癌合并肝硬化肝切除术后肝功能衰竭的临床分析[J].肝胆胰外科杂志, 2010, 22 (6) :463-465.
    [7]WEI JB, CHEN SR, PU J, et al.Analysis on risk factors leading incomplete compensation of liver function after hepatectomy for primary liver cancer[J].J Hepatobiliary Surg, 2005, 13 (6) :424-468. (in Chinese) 韦建宝, 陈山荣, 浦涧, 等.肝癌切除术后肝功能代偿不全的危险因素分析[J].肝胆外科杂志, 2005, 13 (6) :424-468.
    [8]DU GJ, WU LQ, ZHU CZ, et al.Predictive factors for liver dysfunction and failure after hepatectomy:analysis of 467 patients with hepatocellular carcinoma[J].Chinese-German J Clinical Oncol, 2012, 11 (4) :210-213.
    [9]HUANG L, LI J, YAN JJ, et al.Prealbumin is predictive for postoperative liver insufficiency in patients undergoin liver resection[J].World J Gastroenterol, 2012, 18 (47) :7021-7025.
    [10]LIU YH, ZHENG XL, ZHENG Z, et al.Perioperative risk factors for liver failure after hepatectomy of primary hepatic carcinoma[J].Chin Gen Pract, 2013, 16 (6) :2036-2038. (in Chinese) 柳已海, 郑小林, 郑直, 等.原发性肝癌肝切除术后患者发生肝功能衰竭的围术期危险因素分析[J].中国全科医学, 2013, 16 (6) :2036-2038.
    [11] XU YX, JIN L, LU WJ, et al.Risk factor analysis and treatment for hepatic failure after hepatectomy for primary liver cancer[J].Changzhou Pract Med, 2013, 29 (4) :217-219. (in Chinese) 徐逸昕, 金雷, 陆维军, 等.原发性肝癌切除术后肝功能衰竭的临床分析[J].常州实用医学, 2013, 29 (4) :217-219.
    [12]XIONG BW, HOU K.Risk factors of the perioperative liver failure after hepatectomy[J].J Chin Modern Med, 2013, 20 (25) :12-16. (in Chinese) 熊邦文, 侯琨.原发性肝癌肝切除后发生肝功能衰竭的围术期相关危险因素[J].中国当代医药, 2013, 20 (25) :12-16.
    [13]IAKOVA P, AWAD SS, TIMCHENKO NA.Aging reduces proliferative capacities of liver by switching pathways of C/EBPalpha growth arrest[J].Cell, 2003, 113 (4) :495-506.
    [14]YOKOYAMA YY, SCHWACHA MG, SAMY TS, et al.Gender dimorphism in immune responses following trauma and hemorrhage[J].Immunol Res, 2002, 26 (1-3) :63-76.
    [15]ZENG DX, LIN M, CHUN X.The clinical significance of detection of serum prealbumin in patients with hepatopathy[J].The J Med Theory Pract, 2010, 23 (11) :1314-1315. (in Chinese) 曾东晓, 林梅, 春祥.肝病患者血清前自蛋白检测的临床价值分析[J].医学理论与实践, 2010, 23 (11) :1314-1315.
    [16]FANG ML.Prognostic values of serum prealbumin and alpha-fetoprotein levels in patients with severe hepatitis[J].J Clin Exp Med, 2012, 11 (18) :1509-1510. (in Chinese) 方美丽.血清前白蛋白及甲胎蛋白水平在预测重型肝炎患者转归中的价值[J].临床和实验医学杂志, 2012, 11 (18) :1509-1510.
    [17]AWAD S, CONSTANTIN-TEODOSIU D, MACDONALD IA, et al.Short-term starvation and mitochondrial dysfunction–a possible mechanism leading to postoperative insulin resistance[J].Clin Nutr, 2009, 28 (5) :497-509.
    [18]IMAMURA H, SEYAMA Y, KOKUDO N, et al.One thousand fifty-six hepatectomies without mortality in 8 years[J].Arch Surg, 2003, 138 (11) :1198-1206.
    [19]EGNCHI S, IJTSMA AJ, SLCOFF MJ, et al.Outcome and pattern of recurrerlee after curative resection for hepatocellular carcinoma in patients with a normal liver compared to patients with a diseased liver[J].Hepatogastroenterology, 2006, 53 (70) :592-596.
    [20]TIBERIO GA, TIBERIO L, BENETTI A, et al.IL-6 promotes compensatory liver regeneration in cirrhotic rat liver after partial hepatectomy[J].Cytokine, 2008, 42 (3) :372-378.
    [21]POON RT, FAN ST, LO CM, et al.Extended hepatic resection for hepatocellular carcinoma in patients with cirrhosis:is it justified?[J].Ann Surg, 2002, 236 (5) :602-611.
    [22]LEE SG, HWANG S.How I do it:assessment of hepatic functional reserve for indication of hepatic resection[J].J Hepatobiliary Pancreat Surg, 2005, 12 (1) :38-43.
    [23]HUANG CY, HUANG JF, CHEN YL, et al.The surgical treatment of primary hepotacellular carcinoma with tumor thrombi in portal vein[J].J Hepatobiliary Surg, 2005, 13 (6) :253-255. (in Chinese) 黄长玉, 黄建富, 陈燕凌, 等.原发性肝细胞癌合并门静脉癌栓的外科治疗[J].肝胆外科杂志, 2005, 13 (6) :253-255.
    [24]YUAN JL, LIU CH, ZHAO CQ.Studies on relevant gactors of Child-Pugh grading inhepatic cirrhosis[J].J Clin Hepatol, 2011, 27 (3) :270-272. (in Chinese) 袁继丽, 刘成海, 赵长青.肝硬化Child-Pugh评分的相关因素分析[J].临床肝胆病杂志, 2011, 27 (3) :270-272.
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