Preoperative mean corpuscular hemoglobin affecting long-term outcomes of hepatectomized patients with hepatocellular carcinoma.

Pinzhu Huang,Ruhai Zou,Binkui Li,Yun Zheng,Zemin Hu,Chunhong Liu,Jun Huang,Yunfei Yuan

doi:10.3892/mco.2015.705

Abstract

Pretreatment anemia has been reported to be associated with survival in several solid tumor types. In terms of survival, only limited data on the hemoglobin (HGB) level in hepatocellular carcinoma (HCC) have been published and no data on mean corpuscular hemoglobin (MCH) level in HCC is available. The present study sought to examine the role of HGB and MCH levels in predicting long-term survival of patients with HCC who undergo resection. A retrospective study of 399 consecutive patients (1987-1994) who underwent hepatic resection for HCC in Sun Yat-Sen University Cancer Centre was performed. Serum HGB and MCH levels were examined preoperatively, and their prognostic capabilities were evaluated by Cox's proportional hazard model. Among the whole cohort, the HGB level appeared to be positively correlated with the MCH level (P<0.001). Survival analysis revealed that low levels of HGB (P=0.007) and MCH (P<0.001) were correlated with shorter overall survival (OS). Multivariate analysis revealed that MCH level was independently associated with OS (P<0.001), however, not HGB (P=0.278). In addition, 129 patients with large HCC (≥10 cm) tended to have a poorer OS (P<0.001) when compared with patients with smaller HCC. On subanalysis of patients with large HCC, MCH level also retained its stratified significance (P=0.001). Along with common clinicopathological variables, these results suggested that MCH, however, not HGB, may be useful in assessing prognosis for patients with HCC who undergo hepatectomy, particularly in identifying patients with large HCC who are most likely benefit from resection.

Highlights

Hepatocellular carcinoma (HCC) is one of the most prevalent tumor types worldwide [1]
Along with common clinicopathological variables, these results suggested that mean corpuscular hemoglobin (MCH), not HGB, may be useful in assessing prognosis for patients with HCC who undergo hepatectomy, in identifying patients with large HCC who are most likely benefit from resection
Low HGB level was only associated with female patients (P=0.029) and low MCH level was associated with female patients (P=0.011) and incomplete encapsulation (P=0.021)

Summary

Introduction

Hepatocellular carcinoma (HCC) is one of the most prevalent tumor types worldwide [1]. Prognosis of patients with HCC who undergo resection differs substantially and large variation is predominantly unexplained. The risk factors for postoperative survival prediction in patients with HCC have been intensively studied [3,4]. The clinical outcomes for patients with HCC with identical clinicopathological characteristics are heterogeneous [5]. Owing to the limitations of current staging systems and advances in the understanding of the biology of HCC, molecular alterations can complement clinical variables in staging systems and guide therapeutic decision‐making [6]. Routine laboratory assessments, including γ‐glutamyl transpeptidase (GGT) [7], monocyte count [8], platelet count [9] and neutrophil‐to‐lymphocyte ratio [10] have been developed to be predictive factors for survival in HCC

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Results

Conclusion