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Impact of postoperative infective complications on long-term survival after liver resection for hepatocellular carcinoma

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机构: [1]Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, 225 Changhai Rd, Shanghai 200438, Peoples R China [2]Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Anaesthesiol, Shanghai, Peoples R China [3]Chinese Univ Hong Kong, Fac Med, Shatin, Hong Kong, Peoples R China [4]Fujian Med Univ, Mengchao Hepatobiliary Hosp, Dept Hepatobiliary Surg, Fuzhou, Fujian, Peoples R China [5]Puer Peoples Hosp, Dept Hepatobiliary Surg, Puer, Yunnan, Peoples R China [6]Fourth Hosp Harbin, Dept Gen Surg 1, Harbin, Heilongjiang, Peoples R China [7]Liuyang Peoples Hosp, Dept Gen Surg, Changsha, Hunan, Peoples R China [8]Ziyang First Peoples Hosp, Dept Gen Surg, Chengdu, Sichuan, Peoples R China [9]Meizhou Peoples Hosp, Dept Hepatobiliary Surg 2, Meizhou, Guangdong, Peoples R China [10]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Hepat Surg, Wuhan, Hubei, Peoples R China [11]Ohio State Univ, Dept Surg, Wexner Med Ctr, Columbus, OH 43210 USA
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Background: Postoperative complications have a great impact on the postoperative course and oncological outcomes following major cancer surgery. Among them, infective complications play an important role. The aim of this study was to evaluate whether postoperative infective complications influence long-term survival after liver resection for hepatocellular carcinoma (HCC). Methods: Patients who underwent resection with curative intent for HCC between July 2003 and June 2016 were identified from a multicentre database (8 institutions) and analysed retrospectively. Independent risk factors for postoperative infective complications were identified. After excluding patients who died 90 days or less after surgery, overall survival (OS) and recurrence-free survival (RFS) were compared between patients with and without postoperative infective complications within 30 days after resection. Results: Among 2442 patients identified, 332 (13.6 per cent) had postoperative infective complications. Age over 60 years, diabetes mellitus, obesity, cirrhosis, intraoperative blood transfusion, duration of surgery exceeding 180 min and major hepatectomy were identified as independent risk factors for postoperative infective complications. Univariable analysis revealed that median OS and RFS were poorer among patients with postoperative infective complications than among patients without (54.3 versus 86.8months, and 22.6 versus 43.2months, respectively; both P < 0.001). After adjustment for other prognostic factors, multivariable Cox regression analyses identified postoperative infective complications as independently associated with decreased OS (hazard ratio (HR) 1.20, 95 per cent c. i. 1.02 to 1.41; P = 0.027) and RFS (HR 1.19, 1.03 to 1.37; P = 0.021). Conclusion: Postoperative infective complications decreased long-term OS and RFS in patients treated with liver resection for HCC.

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基金编号: 81472284 81672699 16PJD004

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 1 区 外科
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大类 | 1 区 医学
小类 | 1 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者机构: [1]Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, 225 Changhai Rd, Shanghai 200438, Peoples R China
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通讯机构: [1]Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, 225 Changhai Rd, Shanghai 200438, Peoples R China [*1]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai 200438, China
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