Impacts Of Obesity On Post-operative Prognosis Of Hepatocellular Carcinoma

Aims:To study whether obesity is an independent risk factor to impact the post operative prognosis of hepatocellular carcinoma(HCC),including post-operative complications,tumor-free survival time,overall survival time and survival rate,etc.To further explore the influence and significance of reasonable weight loss in the reduction of morbidity and improvement of post-operate prognosis of HCC.Methods:118 cases of HCC patients admitted from January 2010 to December2014 who underwent hepatectomy at China-Japan Union Hospital of Jilin University were analyzed retrospectively.According to the body mass index(BMI),the patients were divided into obese and non-obese groups with 25kg/m2 as the cut-off value.Obese group of 41 cases,including 32 males and 9 females;non-obese group of 77 cases,including 62 males and 15 females.The incidence of complications,tumor-free survival time,overall survival time,and survival rate between two groups were analyzed by Kaplan-Meier survival curve and Log-Rank test,Mann-Whitney U test,T test,and ?2 test.Results:In comparison of obese vs non-obese group,the incidence of postoperative complications were 17.1% vs 20.8%(P>0.05);Postoperative tumor-free survival time were 16.01 months vs 25.49months(P<0.05);Median tumor-free survival time were 9 months vs 24months(P <0.05);The overall survival time were 28.27 ± 17.91 months vs 36.37 ± 19.30months(P <0.05);Median survival time were 26 months vs 37 months(P <0.05).1year,2 years,3 years,4 years,and 5 years tumor-free survival rate were 34.1%,24.4%,22.6%,19.2%,and 16.7% in obese group,and 66.2%,51.9%,31.7%,30.2%,and 28.6% in non-obese group,respectively.The overall 1-5 years survival rate were 82.9%,58.5%,32.3%,26.9%,and 25.0% in obese group,and 89.6%,77.9%,65.1%,53.5%,and 42.9% in non-obese group,respectively.There was no significant difference in the incidence of postoperative complications between the two groups(P> 0.05),the disease-free survival time and the overall survival time of obese group were significantly lower than those of non-obese group(P <0.05).Kaplan-Meier survival curve of the two groups,after the Log Rank test,P <0.05,there were statistical differences.Univariate analysis showed that the tumor size,tumor number,AFP level,differentiation and grade,micro-vascular invasion,and BMI impacted the tumor recurrence after surgical resection.The tumor size,number,differentiation grade,micro-vascular invasion,and BMI also impacted the postoperative survival.Cox multivariate analysis showed that tumor differentiation,micro-vascular invasion and BMI were independent risk factors for recurrence after resection,and tumor size,tumor number,micro-vascular invasion and BMI were independent risk factors for survival.Conclusions:The disease-free survival time,overall survival time and survivalrate of obese patients with HCC were significantly lower than those of non-obese patients;This is suggesting that obesity may promote the development of HCC and can be counted as an independent risk factor which impact the prognosis of HCC.