Impact of low skeletal muscle mass index and perioperative blood transfusion on the prognosis for HCC following curative
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RESEARCH ARTICLE
Open Access
Impact of low skeletal muscle mass index and perioperative blood transfusion on the prognosis for HCC following curative resection Tomoaki Bekki1, Tomoyuki Abe1* , Hironobu Amano1,2, Minoru Hattori3, Tsuyoshi Kobayashi2, Masahiro Nakahara1, Hideki Ohdan2 and Toshio Noriyuki1,2
Abstract Background: This study aimed to assess the prognostic factors including low skeletal muscle mass index (SMI) and perioperative blood transfusion for patients with hepatocellular carcinoma (HCC) following curative surgery. Methods: This study included 139 patients with HCC who underwent hepatectomy between 2005 and 2016. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS) and recurrence-free survival (RFS). Results: Low SMI was significantly related with poor OS, while blood transfusion had a strong impact on RFS. The male ratio and body mass index in the low SMI group were significantly higher than those in the high SMI group. There were no significant differences in age, virus etiology, laboratory data, liver function, tumor makers, and operative variables between the groups. Tumor factors such as tumor diameter, tumor number, poor differentiation, and intrahepatic metastasis (IM) did not significantly differ between the two groups. Operation time, intraoperative blood loss volume, and recurrence ratio were significantly higher in the blood transfusion group than in the nontransfusion group. IM was associated with poor OS and RFS. Conclusions: Low SMI and blood transfusion were independently related with long-term prognosis in patients with HCC following curative surgery. Keywords: Blood transfusion, Hepatocellular carcinoma, Low SMI
* Correspondence: [email protected] 1 Department of Surgery, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Bekki et al. BMC Gastroenterology
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