Abstract
Although cholecystectomy has been reported to be associated with increased risk of developing hepatocellular carcinoma (HCC), the association between cholecystectomy and prognosis of HCC patients underwent curative resection has never been examined. Through retrospective analysis of the data of 3933 patients underwent curative resection for HCC, we found that cholecystectomy was an independent prognostic factor for recurrence-free survival (RFS) of patients at early stage (BCLC stage 0/A) (p = 0.020, HR: 1.29, 95% CI: 1.04–1.59), and the 1-, 3-, 5-year RFS rates for patients at early stage were significantly worse in cholecystectomy group than in non-cholecystectomy group (80.5%, 61.8%, 52.0% vs 88.2%, 68.8%, 56.8%, p = 0.033). The early recurrence rate of cholecystectomy group was significantly higher than that of non-cholecystectomy group for patients at early stage (59/47 vs 236/333, p = 0.007), but not for patients at advanced stage (BCLC stage C) (p = 0.194). Multivariate analyses showed that cholecystectomy was an independent risk factor for early recurrence (p = 0.005, HR: 1.52, 95% CI: 1.13–2.03) of early stage HCC, but not for late recurrence (p = 0.959). In conclusion, cholecystectomy is an independent predictor for early recurrence and is associated with poorer RFS of early stage HCC. Removal of normal gallbladder during HCC resection may be avoided for early stage patients.
Highlights
Reduced recurrence and improvement in overall survival in HBV-related HCC25,26
Since for patients at early stage, the recurrence free survival (RFS) rates of cholecystectomy group were significantly worse than those of non-cholecystectomy group, we further investigated whether cholecystectomy was an independent prognostic factor for RFS of patients at early stage
hepatocellular carcinoma (HCC) is a clear example of inflammation-related cancer as more than 90% of HCC arises in the context of hepatic injury and inflammation, as the result of hepatitis B or C virus infection[28,29,30]
Summary
Reduced recurrence and improvement in overall survival in HBV-related HCC25,26. The decreased incidence of recurrence in patients who have used nonsteroidal anti-inflammatory drugs (NSAIDs), regardless of patients’ viral hepatitis status, is supportive of a role for non-virus related inflammation in HCC recurrence[27]. Since an association is biologically plausible, the relation between cholecystectomy and outcome of HCC merits investigation. We retrospectively analyzed the data of 3933 consecutive HCC patients treated by curative resection, to investigate the impact of cholecystectomy on postoperative recurrence and survival of HCC patients
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