Abstract | BACKGROUND: Systemic inflammation before surgery, as evidenced by the Glasgow prognostic score (GPS), predicts postoperative complications and cancer-specific survival in various types of cancer. The aim of this study was to evaluate the significance GPS in hepatic resection for hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Sixty-six patients who underwent elective hepatic resections for HCC were include in the study. Patients were classified into three groups: GPS 0 [ C-reactive protein (CRP)≤1.0 mg/dl and serum albumin ≥3.5 g/dl, n = 54], GPS 1 [CRP >1.0 mg/dl or serum albumin <3.5 g/dl, n = 11], and GPS 2 [CRP>1.0 mg/dl and serum albumin <3.5 g/dl, n = 1]. We retrospectively examined the association between GPS (0 or 1) and perioperative clinical variables and outcome. RESULTS: In univariate analysis, GPS 0 patients had significantly better preoperative the retention rate of indocyanine green at 15 minutes (ICGR15) (p=0.0418), Child-Pugh classification (p = 0.0075) and model for end-stage liver disease score (p = 0.0007) than did GPS 1 patients. In multivariate analysis, blood loss and GPS 1 were independent risk factors for pulmonary complications (p = 0.0118 for blood loss, p = 0.0143 for GPS 1), red blood cell concentration transfusion (p = 0.0036 for blood loss, p = 0.0117 for GPS 1) and flesh frozen plasma transfusion (p = 0.0020 for blood loss, p = 0.0044 for GPS 1). Albumin product transfusion, duration of operation (p = 0.0478), blood loss (p = 0.0420) and GPS 1 (p = 0.0111) were independent risk factors. Disease-free and overall survival of GPS 0 and GPS 1 patients were comparable. CONCLUSION: GPS reflects preoperative patient status, and is associated with blood transfusion and pulmonary complications in elective hepatic resection for HCC.
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Authors | Yuki Fujiwara, Hiroaki Shiba, Kenei Furukawa, Tomonori Iida, Koichiro Haruki, Takeshi Gocho, Shigeki Wakiyama, Shoichi Hirohara, Yuichi Ishida, Takeyuki Misawa, Toya Ohashi, Katsuhiko Yanaga |
Journal | Anticancer research
(Anticancer Res)
Vol. 30
Issue 12
Pg. 5129-36
(Dec 2010)
ISSN: 1791-7530 [Electronic] Greece |
PMID | 21187501
(Publication Type: Journal Article)
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Chemical References |
- Serum Albumin
- C-Reactive Protein
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Topics |
- Analysis of Variance
- Blood Loss, Surgical
- Blood Transfusion
- C-Reactive Protein
(metabolism)
- Carcinoma, Hepatocellular
(blood, pathology, surgery)
- Disease-Free Survival
- Female
- Glasgow Outcome Scale
- Humans
- Inflammation
(blood, complications, pathology)
- Liver Neoplasms
(blood, pathology, surgery)
- Male
- Middle Aged
- Perioperative Period
- Postoperative Complications
(etiology)
- Risk Factors
- Serum Albumin
(metabolism)
- Survival Rate
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