Association between preoperative prealbumin level and postoperative mortality and morbidity after hepatic resection for hepatocellular carcinoma: A multicenter study from a HBV-endemic area.

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Date: May 2021
From: The American Journal of Surgery(Vol. 221, Issue 5)
Publisher: Elsevier B.V.
Document Type: Report
Length: 666 words

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Abstract :

Keywords Hepatocellular carcinoma; Hepatectomy; Prealbumin; Morbidity; Mortality Highlights * Prealbumin is a more sensitive serum biomarker in reflecting liver function and nutritional status than albumin. * Prealbumin level could hardly be affected by supplemental venous infusion of albumin or blood transfusion. * From a Chinese multicenter database, 1,356 patients treated with hepatic resection were enrolled into this study. * Prealbumin level, but not albumin level, was independently associated with postoperative mortality and morbidity. * Preoperative prealbumin level could be used to predict postoperative morbidity and mortality after hepatic resection. Abstract Background Prealbumin 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). Methods From 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. Results Among 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 Conclusions Preoperative prealbumin level could be used to predict postoperative morbidity and mortality for patients treated with hepatic resection for HCC. Abbreviations HCC, hepatocellular carcinoma; BMI, Body mass index; ALBI, Albumin-bilirubin; ASA, American Society of Anesthesiologists; HCV, Hepatitis C virus; MELD, Model for end-stage liver disease; INR, International normalized ratio; ALT, Alanine aminotransferase; AST, Aspartate transaminase; SD, Standard deviation; OR, Odds ratio; 95% CI, 95% confidence interval Author Affiliation: (a) Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai, China (b) Department of General Surgery, Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai, China (c) Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China (d) Department of Hepatobiliary Surgery, Fuyang People's Hospital, Anhui, China (e) The First Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang, China (f) Department of General Surgery, Liuyang People's Hospital, Hunan, China (g) Department of General Surgery, Ziyang First People's Hospital, Sichuan, China (h) Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fujian, China (i) Department of Hepatobiliary Surgery, Pu'er People's Hospital, Yunnan, China (j) Department of Hepatobiliary Surgery, Chongqing University Cancer Hospital, Chongqing, China (k) The 2nd Department of Hepatobiliary Surgery, Meizhou People's Hospital, Guangdong, China (l) Department of Hepatobiliary Surgery, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, China (m) Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China * Corresponding author. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai 200438, China. Article History: Received 9 June 2020; Revised 24 July 2020; Accepted 26 August 2020 Byline: Ju-Dong Li (a,b), Yong-Kang Diao (c), Jie Li (d), Han Wu (a), Li-Yang Sun (a), Wei-Min Gu (e), Hong Wang (f), Ting-Hao Chen (g), Yong-Yi Zeng (h), Ya-Hao Zhou (i), Yu Wang (j), Yao-Ming Zhang (k), Ying-Jian Liang (l), Wan Yee Lau (a,m), Chao Li (a), Lei Liang (a), Ming-Da Wang (a), Cheng-Wu Zhang (c), Feng Shen (a), Cheng-Hao Shao [shaochenghao_czyy@163.com] (b,**), Tian Yang [yangtiandfgd@hotmail.com] (a,*)

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Gale Document Number: GALE|A660585144