Tomimaru Y, Wada H, Marubashi S, Kobayashi S, Eguchi H, Takeda Y, Tanemura M, Noda T, Umeshita K, Doki Y, Mori M, Nagano H. Fresh frozen plasma transfusion does not affect outcomes following hepatic resection for hepatocellular carcinoma. World J Gastroenterol 2010; 16(44): 5603-5610 [PMID: 21105194 DOI: 10.3748/wjg.v16.i44.5603]
Corresponding Author of This Article
Hiroaki Nagano, MD, PhD, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka E-2, Suita, 565-0871, Osaka, Japan. hnagano@gesurg.med.osaka-u.ac.jp
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World J Gastroenterol. Nov 28, 2010; 16(44): 5603-5610 Published online Nov 28, 2010. doi: 10.3748/wjg.v16.i44.5603
Table 1 Comparison of perioperative characteristics between Group A (1983-1993) and Group B (1998-2006), and between Group B1 and Group B2 n (%)
Group A (1983-1993) (n = 204)
Group B (1998-2006) (n = 297)
P-value
Group B
P-value
Group B1 (n = 22)
Group B2 (n = 275)
Age (yr)
< 60
114 (55.9)
207 (69.7)
0.0015
9 (40.9)
81 (29.5)
NS
≥ 60
90 (44.1)
90 (30.3)
13 (59.1)
194 (70.5)
Gender
Male
178 (87.3)
235 (79.1)
0.0188
20 (90.9)
215 (78.2)
NS
Female
26 (12.7)
62 (20.9)
2 (9.1)
60 (21.8)
Child-Pugh
A
187 (91.7)
251 (84.5)
0.0176
17 (77.3)
234 (85.1)
NS
B
17 (8.3)
46 (15.5)
5 (22.7)
41 (14.9)
Viral infection
HBV (+)
40/201 (19.9)
56 (18.9)
NS
4 (18.2)
52 (18.9)
NS
HCV (+)
47/78 (60.3)
177 (59.6)
NS
11 (40.9)
166 (61.1)
NS
Surgical procedure
≤ Hr1
171 (83.8)
241 (81.1)
NS
14 (63.6)
227 (82.5)
0.0436
≥ Hr2
33 (16.2)
56 (18.9)
8 (36.4)
48 (17.5)
Intraoperative blood loss (mL)
< 2000
133 (65.2)
247 (83.2)
< 0.0001
1 (4.5)
246 (89.5)
< 0.0001
≥ 2000
71 (34.8)
50 (16.8)
21 (95.5)
29 (10.5)
Use of FFP
(-)
0 (0)
275 (92.6)
< 0.0001
(+)
204 (100.0)
22 (7.4)
Mortality
8 (3.9)
0 (0)
0.0007
0 (0)
0 (0)
--
Morbidity
55 (27.0)
73 (24.6)
NS
9 (40.9)
64 (23.2)
NS
Table 2 Comparison of perioperative characteristics between Group B1≥ 2000 mL and Group B2≥ 2000 mLn (%)
Group B1≥ 2000 mL (n = 21)
Group B2≥ 2000 mL (n = 29)
P-value
Age (yr)
< 60
9 (42.9)
11 (37.9)
NS
≥ 60
12 (57.1)
18 (62.1)
Gender
Male
20 (95.2)
23 (79.3)
NS
Female
1 (4.8)
6 (20.7)
Child-Pugh
A
17 (81.0)
21 (72.4)
NS
B
4 (19.0)
8 (27.6)
Viral infection
HBV (+)
5 (23.8)
3 (10.3)
NS
HCV (+)
9 (42.9)
19 (65.5)
NS
Maximum size of tumor(s) (cm)
8.3 ± 6.3
6.9 ± 4.6
NS
Intrahepatic metastasis
(-)
9 (26.8)
17 (58.6)
NS
(+)
12 (63.2)
12 (41.4)
Vascular involvement
(-)
8 (38.1)
17 (58.6)
NS
(+)
13 (61.9)
12 (41.4)
Operative time (min)
426 ± 154
391 ± 130
NS
Intraoperative blood loss (mL)
5364 ± 1651
2854 ± 1056
< 0.0001
Use of RCC
(-)
3 (14.3)
19 (65.5)
0.0004
(+)
18 (85.7)
10 (34.5)
Surgical procedure
≤ Hr1
14 (66.7)
17 (58.6)
NS
≥ Hr2
7 (33.3)
12 (41.4)
Table 3 Comparison of postoperative complications between Group B1≥ 2000 mL and Group B2≥ 2000 mLn (%)
Group B1≥ 2000 mL (n = 21)
Group B2≥ 2000 mL (n = 29)
P-value
Mortality
0 (0)
0 (0)
--
Morbidity
9 (42.9)
9 (31.0)
NS
Cardiopulmonary
2 (9.5)
0 (0)
Renal dysfunction
0 (0)
0 (0)
Hepatic failure
0 (0)
0 (0)
Bleeding
1 (4.8)
1 (3.4)
Bile leakage
1 (4.8)
2 (6.9)
Ascites and/or pleural effusion
0 (0)
3 (10.3)
Ileus
2 (9.5)
0 (0)
Wound infection
3 (14.3)
3 (10.3)
Table 4 Multivariate analysis of disease-free survival and overall survival after hepatectomy for hepatocellular carcinoma in patients with intraoperative blood loss of ≥ 2000 mL
n
DFS
OS
OR
95% CI
P-value
OR
95% CI
P-value
Maximum size of tumor (cm)
1.553
0.755-3.191
NS
≤ 5
16
> 5
31
Tumor number
2.280
0.874-5.591
NS
Single
24
Multiple
26
Vascular invasion
2.445
1.091-5.464
0.0299
3.203
1.216-8.439
0.0185
(-)
25
(+)
25
RCC transfusion
1.695
0.674-4.261
NS
(-)
22
(+)
28
FFP transfusion
1.340
0.512-3.005
NS
(-)
29
(+)
21
Citation: Tomimaru Y, Wada H, Marubashi S, Kobayashi S, Eguchi H, Takeda Y, Tanemura M, Noda T, Umeshita K, Doki Y, Mori M, Nagano H. Fresh frozen plasma transfusion does not affect outcomes following hepatic resection for hepatocellular carcinoma. World J Gastroenterol 2010; 16(44): 5603-5610