Predictive Factors for Early Mortality after Hepatic Resection for Hepatitis C Virus Related Hepatocellular Carcinoma: A Single Center Experience

Abstract Background: Hepatocellular Carcinoma (HCC) is the most common malignancy affecting the liver. It accounts for almost ninety percentage of primary malignancies affecting the liver. HCC develops on a carcinogenic background of liver cirrhosis. Aim of Study: To evaluate our center experience of liver resection for Hepatitis C Virus (HCV) related Hepatocellular Carcinoma (HCC) to determine the predictive factors of early post-operative mortality. Patients and Methods: We reviewed the data for all consecutive patients who underwent liver resection for HCV related HCC during the period between January 2010 and June 2018. Results: Two hundred fourteenconsecutive patients were included in the study. The median age was 59 years (18-78), and median MELD score was 7 (6-16). The median operation time was 170 minutes (70-380) and median blood loss was 680ml (100-5000). The median hospital stay was 5 days (2-60). Post-operative morbidities occurred in 120 patients (56%). Early post-operative mortality occurred in 19 patients (8.9%), all of them developed variable degrees of post-hepatectomy liver dys-function. The median follow-up duration was 22 months (5-110). Recurrence occurred in 130 patients (60.7%). The 1-, 3-, and 5-years disease-free survival rates were 69.2%, 35.4%, and 17.6%, respectively. Late mortality occurred in 59 patients (27.6%). The 1-, 3-, and 5-years overall survival rates were 78.2%, 59.1%, and 50%, respectively. Predictive factors for early mortalityincluded pre-operative albumin, Child-Pugh score, MELD score, blood loss, severe post-operative morbidities, renal complications, and post-hepatectomy liver dysfunction. Conclusion: Proper selection of liver resection candidates based on pre-operative laboratory findings, together with meticulous surgical techniques to minimize blood loss can help to avoid early post-operative mortality.