This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Preoperative serum hyaluronic acid level as a prognostic factor in patients undergoing hepatic resection for hepatocellular carcinoma. BJS 2014; 101: 269-276.

Published: 20th January 2014

Authors: K. Mima, T. Beppu, T. Ishiko, A. Chikamoto, S. Nakagawa, H. Hayashi et al.

Background

Hyaluronic acid (HA) probably plays a critical role in tumorigenesis. The clinical significance of serum HA concentration in patients with hepatocellular carcinoma (HCC) remains to be elucidated. This study analysed the relationship between preoperative serum HA levels and prognosis after hepatic resection in patients with HCC.

Method

Consecutive patients who underwent hepatic resection for HCC between September 1999 and March 2012 were included in this retrospective study. Serum HA levels were measured within 4 weeks before surgery by an immunoturbidimetric automated latex assay. The cut‐off level for preoperative serum HA was validated using a time‐dependent receiver operating characteristic (ROC) curve analysis. The prognostic impact of preoperative serum HA levels was analysed using Cox proportional hazards models.

Results

A total of 506 patients of median age 66 years (405 men, 80·0 per cent) were analysed. The median length of follow‐up was 32 months. High serum HA levels (100 ng/ml or above) were associated with shorter recurrence‐free survival (P < 0·001) (hazard ratio (HR) 1·50, 95 per cent confidence interval 1·17 to 1·93; P = 0·002) and overall survival (P = 0·001) (HR 1·46, 1·03 to 2·07; P = 0·033). In patients with HCC without severe liver fibrosis, serum HA level was correlated with multiple tumours (P = 0·039), early recurrence (P = 0·033), and poor recurrence‐free (P < 0·001) and overall (P = 0·024) survival.

Conclusion

High preoperative serum HA levels predict poor prognosis in patients with HCC after hepatic resection, and may serve as a future biomarker.

Full text

You may also be interested in

Systematic review

Systematic review of functional outcome and quality of life after total pancreatectomy.

Authors: L. Scholten, T. F. Stoop, M. Del Chiaro, O. R. Busch, C. van Eijck, I. Q. Molenaar et al.

Original article

Multicentre observational cohort study of implementation and outcomes of laparoscopic distal pancreatectomy.

Authors: S. Lof, A. L. Moekotte, B. Al‐Sarireh, B. Ammori, S. Aroori, D. Durkin et al.

Systematic review

Meta‐analysis of recurrence pattern after resection for pancreatic cancer.

Authors: M. Tanaka, A. L. Mihaljevic, P. Probst, M. Heckler, U. Klaiber, U. Heger et al.

Original article

Validation of a nomogram to predict the risk of cancer in patients with intraductal papillary mucinous neoplasm and main duct dilatation of 10 mm or less.

Authors: W. Jung, T. Park, Y. Kim, H. Park, Y. Han, J. He et al.

Original article

Multicentre analysis of the learning curve for laparoscopic liver resection of the posterosuperior segments. BJS 2019; 106: 1512-1522.

Authors: G. Berardi, D. Aghayan, Å. A. Fretland, H. Elberm, F. Cipriani, A. Spagnoli et al.

Original article

Secondary technical resectability of colorectal cancer liver metastases after chemotherapy with or without selective internal radiotherapy in the randomized SIRFLOX trial.

Authors: B. Garlipp, P. Gibbs, G. A. Van Hazel, R. Jeyarajah, R. C. G. Martin, C. J. Bruns et al.

Systematic review

Meta‐analysis of the association between primary tumour location and prognosis after surgical resection of colorectal liver metastases.

Authors: X.‐Y. Wang, R. Zhang, Z. Wang, Y. Geng, J. Lin, K. Ma et al.

Original article

Benign hilar bile duct strictures resected as perihilar cholangiocarcinoma. BJS 2019; 106: 1504-1511.

Authors: S. Otsuka, T. Ebata, Y. Yokoyama, T. Igami, T. Mizuno, J. Yamaguchi et al.

Original article

Mortality after liver surgery in Germany. BJS 2019; 106: 1523-1529.

Authors: N. Filmann, D. Walter, E. Schadde, C. Bruns, T. Keck, H. Lang et al.

Original article

Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. BJS 2019; 106: 1372-1380.

Authors: Å. A. Fretland, V. J. Dagenborg, G. M. Waaler Bjørnelv, D. L. Aghayan, A. M. Kazaryan, L. Barkhatov et al.

Original article

Safety and efficacy of transarterial embolization of hepatocellular adenomas. BJS 2019; 106: 1362-1371.

Authors: B. V. van Rosmalen, A. J. Klompenhouwer, J. Jaap de Graeff, M. P. D. Haring, V. E. de Meijer, L. Rifai et al.

Original article

Perioperative outcomes and long‐term quality of life after total pancreatectomy.

Authors: A. Pulvirenti, A. Pea, N. Rezaee, C. Gasparini, G. Malleo, M. J. Weiss et al.