Evidence map›Paper›PMID 38180707›Full record

ArticleAnnals of surgical oncology2024

Perioperative Lymphopenia is Associated with Increased Risk of Recurrence and Worse Survival Following Hepatectomy for Hepatocellular Carcinoma.

Diamantis I Tsilimigras, Yutaka Endo, Francesca Ratti, Hugo P Marques, François Cauchy, Vincent Lam, George A Poultsides, Irinel Popescu, Sorin Alexandrescu, Guillaume Martel and 8 more

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Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

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  2. Trajectories of postoperative nutritional risk changes in patients with oesophageal cancer and their relationship with symptom recovery-a multicentre longitudinal study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 14 institutions in 9 countries.

Diamantis I TsilimigrasDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Yutaka EndoDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Francesca RattiDepartment of Surgery, Ospedale San Raffaele, Milan, Italy.
Hugo P MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
François CauchyDepartment of Hepatobiliopancreatic Surgery, APHP, Beaujon Hospital, Clichy, France.
Vincent LamDepartment of Surgery, Westmead Hospital, Sydney, NSW, Australia.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, CA, USA.
Irinel PopescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Sorin AlexandrescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Guillaume MartelDepartment of Surgery, University of Ottawa, Ottawa, ON, Canada.
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Alfredo GuglielmiDepartment of Surgery, University of Verona, Verona, Italy.
Tom HughDepartment of Surgery, School of Medicine, The University of Sydney, Sydney, NSW, Australia.
Luca AldrighettiDepartment of Surgery, Ospedale San Raffaele, Milan, Italy.
Ana GleisnerDepartment of Surgery, University of Colorado, Denver, CO, USA.
Feng ShenDepartment of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Itaru EndoYokohama City University School of Medicine, Yokohama, Japan.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. tim.pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870
The Ohio State University Wexner Medical Center · USInstitutul Clinic Fundeni · ROIRCCS Ospedale San Raffaele · ITHôpital Beaujon · FRHospital Curry Cabral · PTKeio University · JPSecond Military Medical University · CNStanford University · USThe University of Sydney · AUUniversity of Colorado Denver · USUniversity of Ottawa · CAUniversity of Verona · ITWestmead Hospital · AUYokohama City University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionImmune dysregulation may be associated with cancer progression. We sought to investigate the prognostic value of perioperative lymphopenia on short- and long-term outcomes among patients undergoing resection of hepatocellular carcinoma (HCC).

methodsPatients undergoing resection of HCC between 2000 and 2020 were identified using an international database. The incidence and impact of perioperative lymphopenia [preoperative, postoperative day (POD) 1/3/5], defined as absolute lymphocyte count (ALC) <1000/μL, on short- and long-term outcomes was assessed.

resultsAmong 1448 patients, median preoperative ALC was 1593/μL [interquartile range (IQR) 1208-2006]. The incidence of preoperative lymphopenia was 14.0%, and 50.2%, 45.1% and 35.6% on POD1, POD3 and POD5, respectively. Preoperative lymphopenia predicted 5-year overall survival (OS) [lymphopenia vs. no lymphopenia: 49.1% vs. 66.1%] and 5-year disease-free survival (DFS) [25.0% vs. 41.5%] (both p < 0.05). Lymphopenia on POD1 (5-year OS: 57.1% vs. 71.2%; 5-year DFS: 30.0% vs. 41.1%), POD3 (5-year OS: 57.3% vs. 68.9%; 5-year DFS: 35.4% vs. 42.7%), and POD5 (5-year OS: 53.1% vs. 66.1%; 5-year DFS: 32.8% vs. 42.3%) was associated with worse long-term outcomes (all p < 0.05). Patients with severe lymphopenia (ALC <500/μL) on POD5 had worse 5-year OS and DFS (5-year OS: 44.7% vs. 54.3% vs. 66.1%; 5-year DFS: 27.8% vs. 33.3% vs. 42.3%) [both p < 0.05], as well as higher incidence of overall (45.5% vs. 25.3% vs. 30.9%; p = 0.013) and major complications (18.2% vs. 3.4% vs. 4.5%; p < 0.001) versus individuals with moderate (ALC 500-1000/μL) or no lymphopenia following hepatectomy for HCC. After adjusting for competing risk factors, prolonged lymphopenia was independently associated with higher hazards of death [hazard ratio (HR) 1.38, 95% CI 1.11-1.72] and recurrence (HR 1.22, 95% CI 1.02-1.45).

conclusionPerioperative lymphopenia had short- and long-term prognostic implications among individuals undergoing hepatectomy for HCC.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsLymphopeniaDisease-Free SurvivalHepatectomyHumansPrognosisRetrospective StudiesHCCLymphopeniaResectionSurgerySurvival

Identifiers

PMID38180707
OpenAlexW4390616188

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.