Prognostic impact of metabolic syndrome on outcomes in patients with hepatitis B-related primary hepatocellular carcinoma following hepatectomy

Abstract

Abstract: Objective To investigate the prognostic influence of metabolic Syndrome (MetS) on the postoperative outcomes of patients afflicted with hepatitis B-associated primary hepatocellular carcinoma (HCC) following hepatectomy. Methods Retrospective analyses was performed on 113 HCC patients(89 males and 24 females, mean age 52 years) treated between January 2013 and June 2018. Patients meeting the criteria for HCC and MetS were categorized into MetS and non-MetS groups. Clinical and surgical parameters were compared between these groups. Primary endpoints included overall survival rate and recurrence-free survival rate. Univariate analyses were conduced using T-test, Mann-Whitney U-test, or Chi-square tests as appropriate. Differences in survival rates and recurrence-free survival rates between groups were evaluated using the, log-rank test. Results In the MetS group, the median age was 55 (IQR: 45-62) years, with 27 males(65.8%), a mean BMI of 26.4±4.0 kg/m², a median WBC count of 5.7× 10⁹/L (IQR: 4.2-7.7) and 24 cases (58.5%) of cirrhosis. These metrics were significantly different from the non-MetS group, which had a median age of 50 years (IQR: 43-59), 62 males (86.1%), a mean BMI of 23.0±3.7 kg/m², a median WBC count of 3.5×10⁹/L(IQR: 2.6-4.9), and 11 cases (26.8%) of cirrhosis(P<0.05). Additionally, the MetS group had higher incidences of cirrhosis and steatohepatitis at 58.5%(24 cases) and 26.8%(11 cases), respectively, compared to 34.7%(25 cases) and 9.7%(7 cases) in, the non-MetS group(P<0.05). Liver failure and hyperglycemia were also more prevalent in the MetS group at 12.2%(5 cases) and 26.8%(11 cases) respectively, versus 2.8%(2 cases) and 9.7%(7 cases) in the non-MetS group(P<0.05). Clavien-Dindo grades in the MetS group( 8 cases at 19.5%, 12 cases at 29.3%, 5 cases at 12.2%, 2 cases at 4.9%) differed significantly from those , in the non-MetS group(17 cases at 23.6%, 5 cases at 6.9%, 5 cases at 6.9%)(P<0.05). The comprehensive complication index was significantly higher in the MetS group(median: 8.5, IQR: 0-12.0) compared to the non-MetS group(median: 0, IQR: 0- 8.0)(P<0.05). Over a median follow-up of 42 months(IQR: 4-60), the 5-year overall survival rate was 63.4%(26/41) in the MetS group and 80.5% (58/72) in the non-MetS group, while the recurrence-free survival rates were 51.2% (21/41) and 63.9% (53/72) respectively, both differences being statistically significant (P<0.05). Conclusion When HCC is complicated with MetS, the postoperative complications tend to be more severe, and the overall survival prognosis worsens. This indicates a critical need for meticulous atteintion to metabolic disorders in patients with HCC.

Key words: Primary hepatocellular carcinoma, Hepatitis B virus, Metabolic syndrome, Clavien-Dindo classification, Overall survival rate

WU Jian, WANG Lian-cai, WANG Ya-feng, DU Chang-shun, XIAO Jian-an. Prognostic impact of metabolic syndrome on outcomes in patients with hepatitis B-related primary hepatocellular carcinoma following hepatectomy[J]. Chinese Hepatolgy, 2024, 29(1): 91-94.

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