Evidence map›Paper›PMID 40739081›Full record

ArticleHepatology international2025

Stage-specific impact of portal hypertension on outcomes after liver resection in hepatocellular carcinoma.

Yukihiro Watanabe, Masayasu Aikawa, Yoshiki Murase, Kenichiro Takase, Yuichiro Watanabe, Hiroaki Ono, Katsuya Okada, Kojun Okamoto, Isamu Koyama

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In one paragraph

Article in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Yukihiro WatanabeDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. watanb@saitama-med.ac.jp.ORCID http://orcid.org/0000-0002-3983-6855
Masayasu AikawaDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Yoshiki MuraseDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Kenichiro TakaseDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Yuichiro WatanabeDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Hiroaki OnoDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Katsuya OkadaDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Kojun OkamotoDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Isamu KoyamaDepartment of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe impact of clinically significant portal hypertension (CSPH) on patients with hepatocellular carcinoma (HCC) after liver resection remains controversial. This study evaluated the effect of CSPH on postoperative outcomes in very-early, early, and intermediate-stage HCC.

methodsIn total, 857 patients with HCC undergoing liver resection were identified from a single-institution database. Patients were stratified using the Japan integrated staging (JIS) score, which combines Child-Pugh grade (A: 0, B: 1, C: 2) and TNM stage (I: 0, II: 1, III: 2, IV: 3). Patients were categorized as very-early (JIS 0, n = 198), early (JIS 1, n = 272), and intermediate (JIS 2-4, n = 287). Multivariable Cox regression assessed overall survival (OS).

resultsRisk-adjusted hazard ratios [95% confidence intervals] for OS in CSPH versus non-CSPH patients were 2.18 [1.14-4.18] (very-early), 0.67 [0.40-1.11] (early), and 1.67 [1.10-2.56] (intermediate). In early stage HCC, CSPH had no significant impact on OS, liver failure (19% vs. 19%, p = 0.925), 90-day mortality (2.6% vs. 2.9%, p = 1.000), or liver decompensation-related death (12% vs. 15%, p = 0.758). However, CSPH patients in very-early and intermediate stages had significantly higher liver failure (0.7% vs. 6.9%, p = 0.027; 6.0% vs. 19%, p = 0.001) and decompensation-related deaths (3.3% vs. 18%, p = 0.027; 9.0% vs. 34%, p < 0.001).

conclusionsCSPH's impact varied by stage. In early stage HCC, CSPH had minimal effect on survival. However, in very-early and intermediate stages, CSPH was associated with worse outcomes. Refining surgical criteria for patients who have HCC with CSPH is essential to balance oncological benefits and hepatic risks.

Indexed as

Carcinoma, HepatocellularHepatectomyHypertension, PortalLiver NeoplasmsAgedFemaleHumansMaleMiddle AgedNeoplasm StagingRetrospective StudiesTreatment OutcomeCirrhosisClinically significant portal hypertensionCohort studyJapan integrated staging (JIS) scoreLiver decompensationMinimally invasive surgeryOverall survivalPostoperative outcomesPrognostic factorStage-based analysis

Identifiers

PMID40739081
PMCPMC12715045

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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.