BACKGROUND: Obesity has been associated with poor oncologic outcomes following pancreatoduodenectomy for pancreatic cancer. However, there is a paucity of evidence on the impact of obesity on postoperative complications, oncologic outcome and survival in patients with hepatocellular carcinoma (HCC) undergoing orthotopic liver transplantation (OLT). METHODS: From a database of over 1000 patients who underwent OLT during 1996-2008, 159 patients with a diagnosis of HCC were identified. Demographic data, body mass index (BMI), perioperative parameters, recurrence and survival were obtained. Complications were grouped according to Clavien-Dindo grading (Grades I-V). RESULTS: There were increased incidences of life-threatening complications in overweight (58%) and obese (70%) patients compared with the non-obese patient group (41%) (P < 0.05). Furthermore, the incidence of recurrence of HCC was doubled in the presence of overweight (15%) and obesity (15%) compared with non-obesity (7%) (P < 0.05). Time to recurrence also decreased significantly. Differences in mean ± standard deviation survival in the overweight (45 ± 3 months) and obese (41 ± 4 months) groups compared with the non-obese group (58 ± 6 months) did not reach statistical significance. CONCLUSIONS: These findings indicate that BMI is an important surrogate marker for obesity and portends an increased risk for complications and a poorer oncologic outcome following OLT for HCC.
BACKGROUND:Obesity has been associated with poor oncologic outcomes following pancreatoduodenectomy for pancreatic cancer. However, there is a paucity of evidence on the impact of obesity on postoperative complications, oncologic outcome and survival in patients with hepatocellular carcinoma (HCC) undergoing orthotopic liver transplantation (OLT). METHODS: From a database of over 1000 patients who underwent OLT during 1996-2008, 159 patients with a diagnosis of HCC were identified. Demographic data, body mass index (BMI), perioperative parameters, recurrence and survival were obtained. Complications were grouped according to Clavien-Dindo grading (Grades I-V). RESULTS: There were increased incidences of life-threatening complications in overweight (58%) and obese (70%) patients compared with the non-obesepatient group (41%) (P < 0.05). Furthermore, the incidence of recurrence of HCC was doubled in the presence of overweight (15%) and obesity (15%) compared with non-obesity (7%) (P < 0.05). Time to recurrence also decreased significantly. Differences in mean ± standard deviation survival in the overweight (45 ± 3 months) and obese (41 ± 4 months) groups compared with the non-obese group (58 ± 6 months) did not reach statistical significance. CONCLUSIONS: These findings indicate that BMI is an important surrogate marker for obesity and portends an increased risk for complications and a poorer oncologic outcome following OLT for HCC.
Authors: Arjun Gupta; Avash Das; Kaustav Majumder; Nivedita Arora; Helen G Mayo; Preet P Singh; Muhammad S Beg; Siddharth Singh Journal: Am J Clin Oncol Date: 2018-09 Impact factor: 2.339
Authors: Erin K Spengler; Jacqueline G O'Leary; Helen S Te; Shari Rogal; Anjana A Pillai; Abdullah Al-Osaimi; Archita Desai; James N Fleming; Daniel Ganger; Anil Seetharam; Georgios Tsoulfas; Martin Montenovo; Jennifer C Lai Journal: Transplantation Date: 2017-10 Impact factor: 4.939
Authors: Trevor W Reichman; George Therapondos; Maria-Stella Serrano; John Seal; Rachel Evers-Meltzer; Humberto Bohorquez; Ari Cohen; Ian Carmody; Emily Ahmed; David Bruce; George E Loss Journal: World J Hepatol Date: 2015-06-18
Authors: Toine M Lodewick; Thiemo J A van Nijnatten; Ronald M van Dam; Kim van Mierlo; Simon A W G Dello; Ulf P Neumann; Steven W M Olde Damink; Cornelis H C Dejong Journal: HPB (Oxford) Date: 2014-12-16 Impact factor: 3.647