Impact of obesity on the surgical outcome following repeat hepatic resection in Japanese patients with recurrent hepatocellular carcinoma

Table 1 The clinicopathological data of nonobese (BMI < 25 kg/m²) and obese (BMI ≥ 25 kg/m²) patients with hepatocellular carcinoma who underwent a primary curative hepatectomy

Variables	BMI < 25 kg/m2 (n = 240)	BMI≥25 kg/m2 (n = 88)	P value
Age	65.6 ± 9.9	66.0 ± 8.8	0.725
Gender (male:female)	172:68	50:38	< 0.05
Body mass index (kg/m2)	21.6 ± 2.2	27.1 ± 2.0	< 0.01
Diabetes mellitus (%)	23.1	25.3	0.684
Positive HCV antibody (%)	72.1	73.9	0.748
Liver function data
AST (international units/L)	54.8 ± 34.7	48.7 ± 24.0	0.132
Albumin (g/dL)	3.8 ± 0.4	3.9 ± 0.5	0.307
Prothrombin time (%)	87.2 ± 15.2	86.9 ± 15.4	0.881
Child-Pugh class (A:B)	222:18	83:5	0.210
Operative data
Procedures (Hr0/HrS:Hr1/Hr2)	159:81	57:31	0.752
Operation time (min)	208 ± 97	207 ± 80	0.886
Blood loss (g)	534 ± 526	582 ± 596	0.472
Blood transfusion (%)	13.3	18.2	0.730
Postoperative complications (%)	11.7	13.6	0.658
Postoperative hospital death (%)	0.8	1.1	0.801
Tumor factors
Tumor size (cm)	3.3 ± 2.4	3.0 ± 1.7	0.337
Solitary tumor (%)	71.3	72.7	0.729
Positive fc (%)	69.3	60.7	0.152
Positive vp (%)	51.1	53.6	0.898
Positive im (%)	9.7	9.5	0.970
Well/Moderately/Poorly1	39/170/20	13/58/8	0.933
AFP (> 20 ng/mL) (%)	52.7	50.6	0.730

BMI: Body mass index; HCV: Hepatitis C virus; AST: Aspartate transaminase; Hr0: Resection less than subsegmentectomy; HrS: Subsegmentectomy; Hr1: Segmentectomy; Hr2: Bisegmentectomy; fc: Capsular formation; vp: Invasion to portal vein; im, intrahepatic metastasis; AFP: Alpha-fetoprotein.

¹Histologic differentiation of the tumor.

Table 2 The clinicopathological data of nonobese (BMI < 25 kg/m²) and obese (BMI ≥ 25 kg/m²) patients with recurrent hepatocellular carcinoma who underwent a repeat hepatectomy

Variables	BMI < 25 kg/m2 (n = 44)	BMI≥25 kg/m2 (n = 16)	P value
Age	67.0 ± 10.3	67.7 ± 7.6	0.809
Gender (male:female)	32:12	7:9	<0.05
Body mass index (kg/m2)	21.9 ± 2.0	26.9 ± 1.3	<0.01
Diabetes mellitus (%)	24.4	20	0.728
Positive HCV antibody (%)	70.5	80	0.463
Liver function data
AST (international units/L)	39.7 ± 24.7	46.8 ± 31.0	0.367
Albumin (g/dL)	4.0 ± 0.5	3.9 ± 0.4	0.427
Prothrombin time (%)	87.7 ± 13.3	83.6 ± 17.7	0.352
Child-Pugh class (A:B)	43:01:00	14:02	0.136
Operative data
Procedures (Hr0/HrS:Hr1/Hr2)	40:4	16:0	0.108
Operation time (min)	188 ± 68	243 ± 100	<0.05
Blood loss (g)	453 ± 336	1044 ± 1120	<0.01
Blood transfusion (%)	6.8	25	0.068
Postoperative complications (%)	9.1	25	0.128
Postoperative hospital death (%)	0	0	0.999
Tumor factors
Tumor size (cm)	2.0 ± 0.8	2.4 ± 1.3	0.197
Solitary tumor (%)	72.3	81.3	0.491
Positive fc (%)	42.9	53.3	0.485
Positive vp (%)	42.9	53.3	0.307
Positive im (%)	11.9	0	0.073
Well/Moderately/Poorly1	6/29/6	5/9/2	0.384
AFP (> 20 ng/mL) (%)	46.5	60	0.367

BMI: Body mass index; HCV: Hepatitis C virus; AST: Aspartate transaminase; Hr0: Resection less than subsegmentectomy; HrS: Subsegmentectomy; Hr1: Segmentectomy; Hr2: Bisegmentectomy; fc: Capsular formation; vp:Invasion to portal vein; im: intrahepatic metastasis; AFP: Alpha-fetoprotein.

¹Histologic differentiation of the tumor.

Table 3 The results of a multivariate analysis using Cox’s proportional hazard model in the patients with recurrent hepatocellular carcinoma who underwent a repeat hepatectomy

Variables	Coefficient	SE	Relative risk	P value
Obesity (BMI ≥ 25 kg/m2)	0.770	0.372	2.160	< 0.05
Tumor size (≥ 2 cm)	0.389	0.438	1.477	0.351
Positive vp	0.466	0.433	1.595	0.254

SE: Standard error; vp: Invasion to portal vein.