Pleural Effusion After Hepatectomy for Hepatocellular Carcinoma: Risk Factor Analyses and Its Impact on Oncological Outcomes
Background Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on onco...
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| Veröffentlicht in: | World journal of surgery 2017-04, Vol.41 (4), p.1089-1099 |
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| creator | Uchiyama, Hideaki Harimoto, Norifumi Itoh, Shinji Yoshizumi, Tomoharu Ikegami, Toru Maehara, Yoshihiko |
| description | Background
Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on oncological outcomes of hepatocellular carcinoma (HCC).
Methods
Medical records of 330 patients who underwent primary curative hepatectomy for HCC were reviewed. All 330 patients had CT around day 7 after hepatectomy, and the emergence of PHPE on CT was examined. Presumed 38 risk factors for the emergence of PHPE and already-known 9 risk factors together with PHPE for HCC recurrence and patient death after hepatectomy were analyzed.
Results
The overall incidence of PHPE was 54.5% (180/330). One hundred seventy-nine and 38 out of the 180 patients had right-sided PHPE and left-sided PHPE, respectively. The independent risk factors for right-sided PHPE were hepatitis B or C back ground, lower preoperative white blood cell count, larger intraoperative blood loss, longer operation time, subcostal incision, and longer total inflow occlusion time, while the only independent risk factor for left-sided PHPE was longer operation time. Left-sided PHPE was testified to be one of the independent risk factors not only for HCC recurrence but also for patient death.
Conclusions
Although the cause of PHPE after hepatectomy might be multifactorial, the emergence of left-sided PHPE is a portent of worse oncological outcomes after curative hepatectomy for HCC and patients with left-sided PHPE need close follow-ups. |
| doi_str_mv | 10.1007/s00268-016-3826-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1881752231</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1843968245</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4552-6762a31587eab4bd4e5543437cfc6e6868a8164c6e44a1fdcc43a8d6b0f7eb13</originalsourceid><addsrcrecordid>eNqFkV9rFDEUxYNY7Lb6AXyRgC--jM3_ZH3bLt12S2FFCz6GTCYpUzOTNZlBFvzwZphVpCB9yg35nXNv7gHgLUYfMULyIiNEhKoQFhVVRFT4BVhgRklFKKEvwQJRwUqN6Sk4y_kRISwFEq_AKZFKEYaXC_Drc3BjMgFeeT_mNvZw5QeX4I3bm8HZIXYH6OPxHq0LYQwmwbVJtu1jZz7BL23-DjemoAmuehMO2WVo-gZuhwy33b68wGK7620M8aG1pdduHGzsXH4NTrwJ2b05nufgfnN1v76p7nbX2_XqrrKMc1IJKYihmCvpTM3qhjnOGWVUWm-FE0ooo7BgpWbMYN9Yy6hRjaiRl67G9Bx8mG33Kf4YXR501-bpK6Z3ccwaK4UlJ9OinkcZXYqyO17Q90_QxzimsoCJklwUktNC4ZmyKeacnNf71HYmHTRGegpRzyHqEqKeQtTTEO-OzmPdueav4k9qBVjOwM82uMPzjvrb7dfLDVIEk6IlszYXWf_g0j9j_3ei338Nt-U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1875684353</pqid></control><display><type>article</type><title>Pleural Effusion After Hepatectomy for Hepatocellular Carcinoma: Risk Factor Analyses and Its Impact on Oncological Outcomes</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Uchiyama, Hideaki ; Harimoto, Norifumi ; Itoh, Shinji ; Yoshizumi, Tomoharu ; Ikegami, Toru ; Maehara, Yoshihiko</creator><creatorcontrib>Uchiyama, Hideaki ; Harimoto, Norifumi ; Itoh, Shinji ; Yoshizumi, Tomoharu ; Ikegami, Toru ; Maehara, Yoshihiko</creatorcontrib><description>Background
Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on oncological outcomes of hepatocellular carcinoma (HCC).
Methods
Medical records of 330 patients who underwent primary curative hepatectomy for HCC were reviewed. All 330 patients had CT around day 7 after hepatectomy, and the emergence of PHPE on CT was examined. Presumed 38 risk factors for the emergence of PHPE and already-known 9 risk factors together with PHPE for HCC recurrence and patient death after hepatectomy were analyzed.
Results
The overall incidence of PHPE was 54.5% (180/330). One hundred seventy-nine and 38 out of the 180 patients had right-sided PHPE and left-sided PHPE, respectively. The independent risk factors for right-sided PHPE were hepatitis B or C back ground, lower preoperative white blood cell count, larger intraoperative blood loss, longer operation time, subcostal incision, and longer total inflow occlusion time, while the only independent risk factor for left-sided PHPE was longer operation time. Left-sided PHPE was testified to be one of the independent risk factors not only for HCC recurrence but also for patient death.
Conclusions
Although the cause of PHPE after hepatectomy might be multifactorial, the emergence of left-sided PHPE is a portent of worse oncological outcomes after curative hepatectomy for HCC and patients with left-sided PHPE need close follow-ups.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-016-3826-1</identifier><identifier>PMID: 27882419</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular - complications ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - surgery ; Cardiac Surgery ; Female ; General Surgery ; Hepatectomy - adverse effects ; Hepatectomy - mortality ; Hepatic Hydrothorax ; Hepatitis B virus ; Humans ; Live Liver Donor ; Liver Neoplasms - complications ; Liver Neoplasms - mortality ; Liver Neoplasms - surgery ; Longe Operation Time ; Male ; Maximum Tumor Diameter ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local - etiology ; Neoplasm Recurrence, Local - mortality ; Oncological Outcome ; Original Scientific Report ; Pleural Effusion - etiology ; Pleural Effusion - mortality ; Retrospective Studies ; Risk Factors ; Surgery ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery ; Young Adult</subject><ispartof>World journal of surgery, 2017-04, Vol.41 (4), p.1089-1099</ispartof><rights>Société Internationale de Chirurgie 2016</rights><rights>2017 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4552-6762a31587eab4bd4e5543437cfc6e6868a8164c6e44a1fdcc43a8d6b0f7eb13</citedby><cites>FETCH-LOGICAL-c4552-6762a31587eab4bd4e5543437cfc6e6868a8164c6e44a1fdcc43a8d6b0f7eb13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-016-3826-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-016-3826-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,41467,42536,45553,45554,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27882419$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uchiyama, Hideaki</creatorcontrib><creatorcontrib>Harimoto, Norifumi</creatorcontrib><creatorcontrib>Itoh, Shinji</creatorcontrib><creatorcontrib>Yoshizumi, Tomoharu</creatorcontrib><creatorcontrib>Ikegami, Toru</creatorcontrib><creatorcontrib>Maehara, Yoshihiko</creatorcontrib><title>Pleural Effusion After Hepatectomy for Hepatocellular Carcinoma: Risk Factor Analyses and Its Impact on Oncological Outcomes</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on oncological outcomes of hepatocellular carcinoma (HCC).
Methods
Medical records of 330 patients who underwent primary curative hepatectomy for HCC were reviewed. All 330 patients had CT around day 7 after hepatectomy, and the emergence of PHPE on CT was examined. Presumed 38 risk factors for the emergence of PHPE and already-known 9 risk factors together with PHPE for HCC recurrence and patient death after hepatectomy were analyzed.
Results
The overall incidence of PHPE was 54.5% (180/330). One hundred seventy-nine and 38 out of the 180 patients had right-sided PHPE and left-sided PHPE, respectively. The independent risk factors for right-sided PHPE were hepatitis B or C back ground, lower preoperative white blood cell count, larger intraoperative blood loss, longer operation time, subcostal incision, and longer total inflow occlusion time, while the only independent risk factor for left-sided PHPE was longer operation time. Left-sided PHPE was testified to be one of the independent risk factors not only for HCC recurrence but also for patient death.
Conclusions
Although the cause of PHPE after hepatectomy might be multifactorial, the emergence of left-sided PHPE is a portent of worse oncological outcomes after curative hepatectomy for HCC and patients with left-sided PHPE need close follow-ups.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Hepatocellular - complications</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Cardiac Surgery</subject><subject>Female</subject><subject>General Surgery</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - mortality</subject><subject>Hepatic Hydrothorax</subject><subject>Hepatitis B virus</subject><subject>Humans</subject><subject>Live Liver Donor</subject><subject>Liver Neoplasms - complications</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - surgery</subject><subject>Longe Operation Time</subject><subject>Male</subject><subject>Maximum Tumor Diameter</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Oncological Outcome</subject><subject>Original Scientific Report</subject><subject>Pleural Effusion - etiology</subject><subject>Pleural Effusion - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkV9rFDEUxYNY7Lb6AXyRgC--jM3_ZH3bLt12S2FFCz6GTCYpUzOTNZlBFvzwZphVpCB9yg35nXNv7gHgLUYfMULyIiNEhKoQFhVVRFT4BVhgRklFKKEvwQJRwUqN6Sk4y_kRISwFEq_AKZFKEYaXC_Drc3BjMgFeeT_mNvZw5QeX4I3bm8HZIXYH6OPxHq0LYQwmwbVJtu1jZz7BL23-DjemoAmuehMO2WVo-gZuhwy33b68wGK7620M8aG1pdduHGzsXH4NTrwJ2b05nufgfnN1v76p7nbX2_XqrrKMc1IJKYihmCvpTM3qhjnOGWVUWm-FE0ooo7BgpWbMYN9Yy6hRjaiRl67G9Bx8mG33Kf4YXR501-bpK6Z3ccwaK4UlJ9OinkcZXYqyO17Q90_QxzimsoCJklwUktNC4ZmyKeacnNf71HYmHTRGegpRzyHqEqKeQtTTEO-OzmPdueav4k9qBVjOwM82uMPzjvrb7dfLDVIEk6IlszYXWf_g0j9j_3ei338Nt-U</recordid><startdate>201704</startdate><enddate>201704</enddate><creator>Uchiyama, Hideaki</creator><creator>Harimoto, Norifumi</creator><creator>Itoh, Shinji</creator><creator>Yoshizumi, Tomoharu</creator><creator>Ikegami, Toru</creator><creator>Maehara, Yoshihiko</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201704</creationdate><title>Pleural Effusion After Hepatectomy for Hepatocellular Carcinoma: Risk Factor Analyses and Its Impact on Oncological Outcomes</title><author>Uchiyama, Hideaki ; Harimoto, Norifumi ; Itoh, Shinji ; Yoshizumi, Tomoharu ; Ikegami, Toru ; Maehara, Yoshihiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4552-6762a31587eab4bd4e5543437cfc6e6868a8164c6e44a1fdcc43a8d6b0f7eb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Hepatocellular - complications</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Cardiac Surgery</topic><topic>Female</topic><topic>General Surgery</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - mortality</topic><topic>Hepatic Hydrothorax</topic><topic>Hepatitis B virus</topic><topic>Humans</topic><topic>Live Liver Donor</topic><topic>Liver Neoplasms - complications</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - surgery</topic><topic>Longe Operation Time</topic><topic>Male</topic><topic>Maximum Tumor Diameter</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Oncological Outcome</topic><topic>Original Scientific Report</topic><topic>Pleural Effusion - etiology</topic><topic>Pleural Effusion - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uchiyama, Hideaki</creatorcontrib><creatorcontrib>Harimoto, Norifumi</creatorcontrib><creatorcontrib>Itoh, Shinji</creatorcontrib><creatorcontrib>Yoshizumi, Tomoharu</creatorcontrib><creatorcontrib>Ikegami, Toru</creatorcontrib><creatorcontrib>Maehara, Yoshihiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uchiyama, Hideaki</au><au>Harimoto, Norifumi</au><au>Itoh, Shinji</au><au>Yoshizumi, Tomoharu</au><au>Ikegami, Toru</au><au>Maehara, Yoshihiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pleural Effusion After Hepatectomy for Hepatocellular Carcinoma: Risk Factor Analyses and Its Impact on Oncological Outcomes</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2017-04</date><risdate>2017</risdate><volume>41</volume><issue>4</issue><spage>1089</spage><epage>1099</epage><pages>1089-1099</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Although posthepatectomy pleural effusion (PHPE) is a commonly observed phenomenon, its precise etiology and the impact of its emergence on oncological outcomes have still unknown. The aim of the current study was to retrospectively investigate risk factors for PHPE and its impact on oncological outcomes of hepatocellular carcinoma (HCC).
Methods
Medical records of 330 patients who underwent primary curative hepatectomy for HCC were reviewed. All 330 patients had CT around day 7 after hepatectomy, and the emergence of PHPE on CT was examined. Presumed 38 risk factors for the emergence of PHPE and already-known 9 risk factors together with PHPE for HCC recurrence and patient death after hepatectomy were analyzed.
Results
The overall incidence of PHPE was 54.5% (180/330). One hundred seventy-nine and 38 out of the 180 patients had right-sided PHPE and left-sided PHPE, respectively. The independent risk factors for right-sided PHPE were hepatitis B or C back ground, lower preoperative white blood cell count, larger intraoperative blood loss, longer operation time, subcostal incision, and longer total inflow occlusion time, while the only independent risk factor for left-sided PHPE was longer operation time. Left-sided PHPE was testified to be one of the independent risk factors not only for HCC recurrence but also for patient death.
Conclusions
Although the cause of PHPE after hepatectomy might be multifactorial, the emergence of left-sided PHPE is a portent of worse oncological outcomes after curative hepatectomy for HCC and patients with left-sided PHPE need close follow-ups.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>27882419</pmid><doi>10.1007/s00268-016-3826-1</doi><tpages>11</tpages></addata></record> |
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| subjects | Abdominal Surgery Adolescent Adult Aged Aged, 80 and over Carcinoma, Hepatocellular - complications Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - surgery Cardiac Surgery Female General Surgery Hepatectomy - adverse effects Hepatectomy - mortality Hepatic Hydrothorax Hepatitis B virus Humans Live Liver Donor Liver Neoplasms - complications Liver Neoplasms - mortality Liver Neoplasms - surgery Longe Operation Time Male Maximum Tumor Diameter Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local - etiology Neoplasm Recurrence, Local - mortality Oncological Outcome Original Scientific Report Pleural Effusion - etiology Pleural Effusion - mortality Retrospective Studies Risk Factors Surgery Thoracic Surgery Treatment Outcome Vascular Surgery Young Adult |
| title | Pleural Effusion After Hepatectomy for Hepatocellular Carcinoma: Risk Factor Analyses and Its Impact on Oncological Outcomes |
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