Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis
Purposes: Whether hepatectomy is justified in patients with hepatocellular carcinoma (HCC) on hemodialysis (HD) for end-stage renal disease (ESRD) is unclear. This study evaluated clinical characteristics and outcomes in patients with HCC on HD for ESRD who underwent hepatectomy.Methods: Hepatectomy...
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| Format: | Article |
| Language: | English |
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Society of Tokyo Women's Medical University
2019-10-01
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| Series: | Tokyo Women's Medical University Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/twmuj/3/0/3_2018002/_pdf/-char/en |
| _version_ | 1818844796765077504 |
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| author | Takaaki Kato Satoshi Katagiri Yoshihito Kotera Shunichi Ariizumi Masakazu Yamamoto |
| author_facet | Takaaki Kato Satoshi Katagiri Yoshihito Kotera Shunichi Ariizumi Masakazu Yamamoto |
| author_sort | Takaaki Kato |
| collection | DOAJ |
| description | Purposes: Whether hepatectomy is justified in patients with hepatocellular carcinoma (HCC) on hemodialysis (HD) for end-stage renal disease (ESRD) is unclear. This study evaluated clinical characteristics and outcomes in patients with HCC on HD for ESRD who underwent hepatectomy.Methods: Hepatectomy was performed in 17 patients in an ESRD group and 181 in a non-ESRD group. We compared clinical characteristics and outcomes between these groups.Results: Compared with the non-ESRD group, the ESRD group had a significantly higher rate of diabetes mellitus, higher serum creatinine levels, lower levels of hemoglobin, aspartate aminotransferase, and alanine aminotransferase, and a lower indocyanine green retention rate at 15 min. There were no significant differences between the 2 groups in other clinical characteristics, laboratory data, surgical outcomes, pathological findings, or overall postoperative morbidity or mortality. However, the incidence of postoperative pneumonia, gastrointestinal bleeding, and intra-abdominal bleeding was significantly higher in the ESRD group. The 5-year disease-free survival rate was 44.3% in the ESRD group and 24.0% in the non-ESRD group (p=0.4483), and the 5-year survival rates were 76.4% and 65.1% (p=0.2291), respectively. HD and serum creatinine levels were not significant prognostic factors for survival and recurrence.Conclusion: Hepatectomy for HCC in patients with ESRD on HD may be associated with increased risk of postoperative pneumonia, gastrointestinal bleeding, and intra-abdominal bleeding, but is feasible if careful surgical and perioperative management are provided. |
| first_indexed | 2024-12-19T05:19:28Z |
| format | Article |
| id | doaj.art-19dafebae5894ebd944ecea2493551f5 |
| institution | Directory Open Access Journal |
| issn | 2432-6186 |
| language | English |
| last_indexed | 2024-12-19T05:19:28Z |
| publishDate | 2019-10-01 |
| publisher | Society of Tokyo Women's Medical University |
| record_format | Article |
| series | Tokyo Women's Medical University Journal |
| spelling | doaj.art-19dafebae5894ebd944ecea2493551f52022-12-21T20:34:32ZengSociety of Tokyo Women's Medical UniversityTokyo Women's Medical University Journal2432-61862019-10-0130344210.24488/twmuj.2018002twmujHepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on HemodialysisTakaaki Kato0Satoshi Katagiri1Yoshihito Kotera2Shunichi Ariizumi3Masakazu Yamamoto4Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical UniversityDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical UniversityDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical UniversityDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical UniversityDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical UniversityPurposes: Whether hepatectomy is justified in patients with hepatocellular carcinoma (HCC) on hemodialysis (HD) for end-stage renal disease (ESRD) is unclear. This study evaluated clinical characteristics and outcomes in patients with HCC on HD for ESRD who underwent hepatectomy.Methods: Hepatectomy was performed in 17 patients in an ESRD group and 181 in a non-ESRD group. We compared clinical characteristics and outcomes between these groups.Results: Compared with the non-ESRD group, the ESRD group had a significantly higher rate of diabetes mellitus, higher serum creatinine levels, lower levels of hemoglobin, aspartate aminotransferase, and alanine aminotransferase, and a lower indocyanine green retention rate at 15 min. There were no significant differences between the 2 groups in other clinical characteristics, laboratory data, surgical outcomes, pathological findings, or overall postoperative morbidity or mortality. However, the incidence of postoperative pneumonia, gastrointestinal bleeding, and intra-abdominal bleeding was significantly higher in the ESRD group. The 5-year disease-free survival rate was 44.3% in the ESRD group and 24.0% in the non-ESRD group (p=0.4483), and the 5-year survival rates were 76.4% and 65.1% (p=0.2291), respectively. HD and serum creatinine levels were not significant prognostic factors for survival and recurrence.Conclusion: Hepatectomy for HCC in patients with ESRD on HD may be associated with increased risk of postoperative pneumonia, gastrointestinal bleeding, and intra-abdominal bleeding, but is feasible if careful surgical and perioperative management are provided.https://www.jstage.jst.go.jp/article/twmuj/3/0/3_2018002/_pdf/-char/enhepatocellular carcinomahepatectomyend-stage renal diseasehemodialysis |
| spellingShingle | Takaaki Kato Satoshi Katagiri Yoshihito Kotera Shunichi Ariizumi Masakazu Yamamoto Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis Tokyo Women's Medical University Journal hepatocellular carcinoma hepatectomy end-stage renal disease hemodialysis |
| title | Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis |
| title_full | Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis |
| title_fullStr | Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis |
| title_full_unstemmed | Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis |
| title_short | Hepatectomy for Hepatocellular Carcinoma in Patients with End-Stage Renal Disease on Hemodialysis |
| title_sort | hepatectomy for hepatocellular carcinoma in patients with end stage renal disease on hemodialysis |
| topic | hepatocellular carcinoma hepatectomy end-stage renal disease hemodialysis |
| url | https://www.jstage.jst.go.jp/article/twmuj/3/0/3_2018002/_pdf/-char/en |
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