Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma
Menée en Chine à partir de données portant sur 1 524 patients atteints d'un carcinome hépatocellulaire traité par résection hépatique curative, cette étude multicentrique analyse la relation entre le poids des patients avant le traitement et le risque de récidive à long terme ou la survie globale
Background : Whether preoperative bodyweight is associated with long-term prognosis in patients after liver resection for hepatocellular carcinoma (HCC) is controversial. This study aimed to investigate the relationship of patient weight with long-term recurrence and overall survival (OS) after curative liver resection for HCC.
Methods : Data for patients with HCC who underwent curative liver resection between 2000 and 2015 in five centres in China were analysed retrospectively in three groups according to their preoperative BMI: underweight (BMI 18·4 kg/m2 or less), normal weight (BMI 18·5–24·9 kg/m2) and overweight (BMI 25·0 kg/m2 or above). Patients' baseline characteristics, operative variables and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors for OS and recurrence‐free survival (RFS) after resection.
Results : Of 1524 patients, 107 (7·0 per cent) were underweight, 891 (58·5 per cent) were of normal weight and 526 (34·5 per cent) were overweight. Univariable analyses showed that underweight and overweight patients had poorer OS (both P < 0·001) and RFS (both P < 0·001) than patients of normal weight. Multivariable Cox regression analysis also identified both underweight and overweight to be independent risk factors for OS (hazard ratio (HR) 1·22, 95 per cent c.i. 1·19 to 1·56, P = 0·019; and HR 1·57, 1·36 to 1·81, P < 0·001, respectively) and RFS (HR 1·28, 1·16 to 1·53, P = 0·028; and HR 1·34, 1·17 to 1·54, P < 0·001).
Conclusion : Underweight and overweight patients appear to have a worse prognosis than those of normal weight following liver resection for HCC.
British Journal of Surgery , résumé, 2017