Evaluation of metabolic factors on the prognosis of patients undergoing resection of hepatocellular carcinoma

J Gastroenterol Hepatol. 2011 Mar;26(3):536-43. doi: 10.1111/j.1440-1746.2010.06439.x.


Background and aim: The metabolic factors including obesity, diabetes, and hypertension have been implicated as risk factors of hepatocellular carcinoma (HCC) in patients with chronic hepatitis. The effects of metabolic factors were investigated on the prognosis of patients undergoing resection of HCC.

Methods: A total of 469 HCC patients were classified into three groups; hepatitis B virus (HBV)-, hepatitis C virus (HCV)-, and non-HBV/HCV (NBC)-related HCC. Further, the patients with HCV-related HCC were sub-classified into three groups; the patients who did not have documented hypertension, hypertensive patients who received angiotensin II-blocking agents (ABA), and hypertensive patients who received no ABA.

Results: There were no significant difference of survival in the HBV-HCC and NBC-HCC patients with or without obesity, diabetes, and hypertension. In the patients with HCV-related HCC, however, hypertensive patients were significantly worse on both disease-free and overall survivals than non-hypertensive patients. Among the HCV-HCC patients with chronic hepatitis, hypertensive patients with ABA had significantly better preoperative liver function, and hypertensive patients without ABA were significantly worse on both disease-free and overall survivals than those of hypertensive patients with ABA and non-hypertensive patients.

Conclusions: Results suggest that hypertension is a risk factor for a poor prognosis after resection of HCV-related HCC. Angiotensin II blockade may improve the prognosis of hypertensive patients with early hepatic fibrosis after resection in HCV-related HCC.

MeSH terms

  • Aged
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Carcinoma, Hepatocellular / etiology
  • Carcinoma, Hepatocellular / metabolism
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery*
  • Chi-Square Distribution
  • Diabetes Complications / etiology
  • Diabetes Complications / surgery
  • Disease-Free Survival
  • Female
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Hepatitis B / complications*
  • Hepatitis B / metabolism
  • Hepatitis B / mortality
  • Hepatitis C / complications*
  • Hepatitis C / metabolism
  • Hepatitis C / mortality
  • Humans
  • Hypertension / complications*
  • Hypertension / drug therapy
  • Hypertension / metabolism
  • Hypertension / mortality
  • Japan
  • Kaplan-Meier Estimate
  • Liver Neoplasms / etiology
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Obesity / complications
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome


  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents