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Erschienen in: World Journal of Surgery 9/2014

01.09.2014

Preoperative Hepatitis B Virus DNA Level is a Risk Factor for Postoperative Liver Failure in Patients Who Underwent Partial Hepatectomy for Hepatitis B-Related Hepatocellular Carcinoma

verfasst von: Gang Huang, Wan Yee Lau, Feng Shen, Ze-ya Pan, Si-yuan Fu, Yun Yang, Wei-ping Zhou, Meng-chao Wu

Erschienen in: World Journal of Surgery | Ausgabe 9/2014

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Abstract

Objective

Our objective was to explore the short-term effects of preoperative serum hepatitis B virus DNA level (HBV DNA) on postoperative hepatic function in patients who underwent partial hepatectomy for hepatitis B-related hepatocellular carcinoma (HCC).

Methods

The clinical data of 1,602 patients with hepatitis B-related HCC who underwent partial hepatectomy in our department were retrospectively studied. The patients were divided into three groups according to their preoperative HBV DNA levels: group A <200 IU/mL, group B 200–20,000 IU/mL, and group C >20,000 IU/mL. The rates of postoperative complications, especially the rate of postoperative liver failure, were compared.

Results

There were significant differences among the three groups in the rates of postoperative liver failure. On multivariate logistic regression analysis, a high preoperative HBV DNA level was an independent risk factor for postoperative liver failure.

Conclusions

Preoperative HBV DNA level was a significant risk factor for postoperative hepatic dysfunction.
Literatur
1.
Zurück zum Zitat El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132(7):2557–2576PubMedCrossRef El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132(7):2557–2576PubMedCrossRef
2.
Zurück zum Zitat Bruix J, Sherman M, American Association for the Study of Liver Diseases (2011) Management of hepatocellular carcinoma: an update. Hepatology 53(3):1020–1022PubMedCentralPubMedCrossRef Bruix J, Sherman M, American Association for the Study of Liver Diseases (2011) Management of hepatocellular carcinoma: an update. Hepatology 53(3):1020–1022PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona 2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35(3):421–430PubMedCrossRef Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona 2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35(3):421–430PubMedCrossRef
4.
Zurück zum Zitat Pang YY (2002) The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000;2:333–39. HPB (Oxford) 4(2):99 author reply 99–100CrossRef Pang YY (2002) The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000;2:333–39. HPB (Oxford) 4(2):99 author reply 99–100CrossRef
5.
Zurück zum Zitat Ishak K, Baptista A, Bianchi L et al (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22(6):696–699PubMedCrossRef Ishak K, Baptista A, Bianchi L et al (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22(6):696–699PubMedCrossRef
6.
Zurück zum Zitat Mullen JT, Ribero D, Reddy SK et al (2007) Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg 204(5):854–862 discussion 862–4PubMedCrossRef Mullen JT, Ribero D, Reddy SK et al (2007) Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg 204(5):854–862 discussion 862–4PubMedCrossRef
8.
Zurück zum Zitat Lok AS, McMahon BJ (2004) AASLD practice guidelines. Chronic hepatitis B: update of therapeutic guidelines. Rom J Gastroenterol 13(2):150–154PubMed Lok AS, McMahon BJ (2004) AASLD practice guidelines. Chronic hepatitis B: update of therapeutic guidelines. Rom J Gastroenterol 13(2):150–154PubMed
10.
Zurück zum Zitat Song TJ, Ip EW, Fong Y (2004) Hepatocellular carcinoma: current surgical management. Gastroenterology 127(5 Suppl 1):S248–S260PubMedCrossRef Song TJ, Ip EW, Fong Y (2004) Hepatocellular carcinoma: current surgical management. Gastroenterology 127(5 Suppl 1):S248–S260PubMedCrossRef
11.
Zurück zum Zitat Detroz B, Sugarbaker PH, Knol JA et al (1994) Causes of death in patients undergoing liver surgery. Cancer Treat Res 69:241–257PubMedCrossRef Detroz B, Sugarbaker PH, Knol JA et al (1994) Causes of death in patients undergoing liver surgery. Cancer Treat Res 69:241–257PubMedCrossRef
12.
Zurück zum Zitat Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1, 803 consecutive cases over the past decade. Ann Surg 236(4):397–406 discussion 406–7PubMedCentralPubMedCrossRef Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1, 803 consecutive cases over the past decade. Ann Surg 236(4):397–406 discussion 406–7PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Simons JP, Hill JS, Ng SC et al (2009) Perioperative mortality for management of hepatic neoplasm: a simple risk score. Ann Surg 250(6):929–934PubMedCrossRef Simons JP, Hill JS, Ng SC et al (2009) Perioperative mortality for management of hepatic neoplasm: a simple risk score. Ann Surg 250(6):929–934PubMedCrossRef
14.
Zurück zum Zitat Schindl MJ, Redhead DN, Fearon KC et al (2005) The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut 54(2):289–296PubMedCentralPubMedCrossRef Schindl MJ, Redhead DN, Fearon KC et al (2005) The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut 54(2):289–296PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Bertoletti A, Gehring AJ (2006) The immune response during hepatitis B virus infection. J Gen Virol 87(Pt 6):1439–1449PubMedCrossRef Bertoletti A, Gehring AJ (2006) The immune response during hepatitis B virus infection. J Gen Virol 87(Pt 6):1439–1449PubMedCrossRef
16.
Zurück zum Zitat Klenerman P, Hill A (2005) T cells and viral persistence: lessons from diverse infections. Nat Immunol 6(9):873–879PubMedCrossRef Klenerman P, Hill A (2005) T cells and viral persistence: lessons from diverse infections. Nat Immunol 6(9):873–879PubMedCrossRef
17.
Zurück zum Zitat Webster GJ, Reignat S, Maini MK et al (2000) Incubation phase of acute hepatitis B in man: dynamic of cellular immune mechanisms. Hepatology 32(5):1117–1124PubMedCrossRef Webster GJ, Reignat S, Maini MK et al (2000) Incubation phase of acute hepatitis B in man: dynamic of cellular immune mechanisms. Hepatology 32(5):1117–1124PubMedCrossRef
18.
Zurück zum Zitat Trobonjaca Z, Kroger A, Stober D et al (2002) Activating immunity in the liver. II. IFN-beta attenuates NK cell-dependent liver injury triggered by liver NKT cell activation. J Immunol 168(8):3763–3770PubMedCrossRef Trobonjaca Z, Kroger A, Stober D et al (2002) Activating immunity in the liver. II. IFN-beta attenuates NK cell-dependent liver injury triggered by liver NKT cell activation. J Immunol 168(8):3763–3770PubMedCrossRef
19.
Zurück zum Zitat Rapicetta M, Ferrari C, Levrero M (2002) Viral determinants and host immune responses in the pathogenesis of HBV infection. J Med Virol 67(3):454–457PubMedCrossRef Rapicetta M, Ferrari C, Levrero M (2002) Viral determinants and host immune responses in the pathogenesis of HBV infection. J Med Virol 67(3):454–457PubMedCrossRef
20.
Zurück zum Zitat Rehermann B, Nascimbeni M (2005) Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol 5(3):215–229PubMedCrossRef Rehermann B, Nascimbeni M (2005) Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol 5(3):215–229PubMedCrossRef
22.
Zurück zum Zitat Lau JY, Wright TL (1993) Molecular virology and pathogenesis of hepatitis B. Lancet 342(8883):1335–1340PubMedCrossRef Lau JY, Wright TL (1993) Molecular virology and pathogenesis of hepatitis B. Lancet 342(8883):1335–1340PubMedCrossRef
23.
Zurück zum Zitat Xie Y, Zhao H, Dai WS et al (2003) HBV DNA level and antigen concentration in evaluating liver damage of patients with chronic hepatitis B. Hepatobiliary Pancreat Dis Int 2(3):418–422PubMed Xie Y, Zhao H, Dai WS et al (2003) HBV DNA level and antigen concentration in evaluating liver damage of patients with chronic hepatitis B. Hepatobiliary Pancreat Dis Int 2(3):418–422PubMed
24.
Zurück zum Zitat Yeo W, Johnson PJ (2006) Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy. Hepatology 43(2):209–220PubMedCrossRef Yeo W, Johnson PJ (2006) Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy. Hepatology 43(2):209–220PubMedCrossRef
25.
Zurück zum Zitat Yeo W, Chan PK, Zhong S et al (2000) Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemotherapy: a prospective study of 626 patients with identification of risk factors. J Med Virol 62(3):299–307PubMedCrossRef Yeo W, Chan PK, Zhong S et al (2000) Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemotherapy: a prospective study of 626 patients with identification of risk factors. J Med Virol 62(3):299–307PubMedCrossRef
26.
Zurück zum Zitat Yeo W, Lam KC, Zee B et al (2004) Hepatitis B reactivation in patients with hepatocellular carcinoma undergoing systemic chemotherapy. Ann Oncol 15(11):1661–1666PubMedCrossRef Yeo W, Lam KC, Zee B et al (2004) Hepatitis B reactivation in patients with hepatocellular carcinoma undergoing systemic chemotherapy. Ann Oncol 15(11):1661–1666PubMedCrossRef
27.
Zurück zum Zitat Nagamatsu H, Kumashiro R, Itano S et al (2003) Investigation of associating factors in exacerbation of liver damage after chemotherapy in patients with HBV-related HCC. Hepatol Res 26(4):293–301PubMedCrossRef Nagamatsu H, Kumashiro R, Itano S et al (2003) Investigation of associating factors in exacerbation of liver damage after chemotherapy in patients with HBV-related HCC. Hepatol Res 26(4):293–301PubMedCrossRef
28.
Zurück zum Zitat Zhong S, Yeo W, Schroder C et al (2004) High hepatitis B virus (HBV) DNA viral load is an important risk factor for HBV reactivation in breast cancer patients undergoing cytotoxic chemotherapy. J Viral Hepat 11(1):55–59PubMedCrossRef Zhong S, Yeo W, Schroder C et al (2004) High hepatitis B virus (HBV) DNA viral load is an important risk factor for HBV reactivation in breast cancer patients undergoing cytotoxic chemotherapy. J Viral Hepat 11(1):55–59PubMedCrossRef
29.
Zurück zum Zitat Jang JW, Choi JY, Bae SH et al (2006) A randomized controlled study of preemptive lamivudine in patients receiving transarterial chemo-lipiodolization. Hepatology 43(2):233–240PubMedCrossRef Jang JW, Choi JY, Bae SH et al (2006) A randomized controlled study of preemptive lamivudine in patients receiving transarterial chemo-lipiodolization. Hepatology 43(2):233–240PubMedCrossRef
Metadaten
Titel
Preoperative Hepatitis B Virus DNA Level is a Risk Factor for Postoperative Liver Failure in Patients Who Underwent Partial Hepatectomy for Hepatitis B-Related Hepatocellular Carcinoma
verfasst von
Gang Huang
Wan Yee Lau
Feng Shen
Ze-ya Pan
Si-yuan Fu
Yun Yang
Wei-ping Zhou
Meng-chao Wu
Publikationsdatum
01.09.2014
Verlag
Springer US
Erschienen in
World Journal of Surgery / Ausgabe 9/2014
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2546-7

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