Achieving textbook outcome in liver resection for hepatocellular carcinoma: malnutrition's pivotal role.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-04-23 DOI:10.1007/s00423-025-03703-x

Kentaro Oji, Takeshi Urade, Satoshi Omiya, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto

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引用次数: 0

Abstract

Purpose: To investigate the impact of textbook outcome (TO) achievement on survival post-liver resection for hepatocellular carcinoma (HCC) and explore the associated factors.

Methods: We retrospectively reviewed 330 patients diagnosed with HCC who underwent initial liver resection at our hospital between January 2011 and December 2019. We also investigated the achievement rates of five TOs and sub-analyzed the relationship between them and malnutrition. The patient's nutritional status was classified following the Global Leadership Initiative on Malnutrition (GLIM) criteria.

Results: The TO achievement rate was 72.7%. In the prognostic analysis, the TO-achieving group showed significantly longer overall survival (OS) and recurrence-free survival (RFS). Significant differences in age, body mass index, weight loss, muscle mass, serum aspartate aminotransferase level, serum protein induced by vitamin K absence or antagonist-II, tumor characteristics, intraoperative blood loss, perioperative transfusion, and nutritional status were found between the groups.

Conclusions: TO achievement is associated with OS and RFS post-liver resection for HCC. The TO is valuable for evaluating treatment quality in liver resection. Additionally, malnutrition graded following the GLIM criteria, age, tumor stage, and intraoperative blood loss are independent factors for achieving a TO post-liver resection for HCC.

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在肝细胞癌的肝切除术中达到教科书的结果：营养不良的关键作用。

目的：探讨教科书预后指标（To）对肝切除术后肝细胞癌（HCC）患者生存的影响及相关因素。方法：我们回顾性分析了2011年1月至2019年12月在我院首次行肝切除术的330例HCC患者。我们还调查了5种TOs的完成率，并分析了它们与营养不良的关系。患者的营养状况按照全球营养不良领导倡议（GLIM）标准进行分类。结果：TO完成率为72.7%。在预后分析中，达到to的组显示出更长的总生存期（OS）和无复发生存期（RFS）。两组患者在年龄、体重指数、体重减轻、肌肉质量、血清天冬氨酸转氨酶水平、缺乏维生素K或拮抗剂ii诱导的血清蛋白、肿瘤特征、术中出血量、围术期输血、营养状况等方面均存在显著差异。结论：肝细胞癌肝切除术后的OS和RFS与TO的实现相关。对评价肝切除术的治疗质量有一定的价值。此外，根据GLIM标准分级的营养不良、年龄、肿瘤分期和术中失血量是HCC肝切除术后实现TO的独立因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.