| Affiliation: | 1. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai, China;2. Department of General Surgery, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai, China;3. Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Zhejiang, China;4. Department of Hepatobiliary Surgery, Fuyang People’s Hospital, Anhui, China;5. The First Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang, China;6. Department of General Surgery, Liuyang People’s Hospital, Hunan, China;7. Department of General Surgery, Ziyang First People’s Hospital, Sichuan, China;8. Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fujian, China;9. Department of Hepatobiliary Surgery, Pu’er People’s Hospital, Yunnan, China;10. Department of Hepatobiliary Surgery, Chongqing University Cancer Hospital, Chongqing, China;11. The 2nd Department of Hepatobiliary Surgery, Meizhou People’s Hospital, Guangdong, China;12. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, China;13. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China;1. Department of Surgery, University of Michigan, Ann Arbor, MI, USA;2. Center for Global Surgery, University of Michigan, Ann Arbor, MI, USA;1. Division of Surgical Oncology, Department of Surgery, Ohio State University Comprehensive Cancer Center and Ohio State University Wexner Medical Center, Columbus, OH, USA;2. School of Medicine and Public Health, University of Wisconsin-Madison, USA;3. Division of Surgical Oncology, Indiana University School of Medicine, Indianapolis, IN, USA;4. Moi Teaching and Referral Hospital, Eldoret, Kenya;5. Division of Endocrine Surgery, University of Wisconsin-Madison, USA;1. Department of Surgery, University of Cincinnati, Cincinnati, OH, USA;1. University of Utah, School of Medicine, United States;2. University of Utah, Department of Surgery, Division of Urology, United States;3. Houston Methodist Hospital, Department of Surgery, United States;4. University of Illinois at Chicago, College of Medicine, United States;5. University of Utah, Department of Internal Medicine, Division of Epidemiology, United States;6. University of Utah, Department of Surgery, Division of Vascular Surgery, United States |
| Abstract: | BackgroundPrealbumin is a more sensitive serum biomarker in reflecting liver function and nutritional status than albumin, because of its shorter half-life and its characteristics that could hardly be affected by supplemental venous infusion of albumin or blood transfusion. This study aimed to identify whether preoperative prealbumin level was associated with postoperative mortality and morbidity after hepatic resection for patients with hepatocellular carcinoma (HCC).MethodsFrom a Chinese multicenter database, patients who underwent hepatic resection for HCC were divided into the low and normal prealbumin groups by using 17 mg/dL as the cut-off level for serum prealbumin taken within a week before surgery. Using univariable and multivariable logistic regression analyses, independent predictors associated with postoperative 30-day and 90-day mortality, 30-day overall and major morbidity, and postoperative hepatic insufficiency were identified.ResultsAmong 1356 patients, 409 (30.2%) had a low preoperative prealbumin level. Postoperative 30-day and 90-day mortality, and 30-day overall and major morbidity in the low prealbumin group were significantly higher than the normal prealbumin group (2.9% vs. 0.5%, 5.1% vs. 1.5%, 35.7% vs. 18.4%, and 14.4% vs. 6.5%, respectively, all P < 0.001). Multivariable analyses identified that preoperative prealbumin level, but not albumin level, was independently associated with postoperative 30-day mortality (OR: 3.486, 95% CI: 1.184–10.265), 90-day mortality (2.504, 1.219–5.145), 30-day overall morbidity (1.727, 1.302–2.292), 30-day major morbidity (1.770, 1.155–2.711) and postoperative hepatic insufficiency (1.967, 1.119–3.427).ConclusionsPreoperative prealbumin level could be used to predict postoperative morbidity and mortality for patients treated with hepatic resection for HCC. |
