Abstract:

Objective The purpose of this study was to explore the impact of preoperative HBV-DNA levels on posthepatectomy liver failure（PHLF）. Methods This prospective cohort study included 342 consecutive Child-Pugh A hepatocellular carcinoma patients who underwent partial hepatectomy. Possible correlations were explored between preoperative HBV-DNA load and PHLF. Results Of the 342 patients，99（29.0%） developed PHLF. Incidence of PHLF by preoperative HBV-DNA load was as follows： >10⁶ IU/mL，42.6%（20/47）；10⁵ IU/mL，29.2%（21/72）；10⁴ IU/mL，34.9%（22/63）；10³ IU/mL，19.7%（11/56）；and ＜10³ IU/mL，24.0%（25/104）. The association between PHLF and HBV-DNA load was not significant（X²=8.900，P=0.064）. Similarly，the association between incidence of PHLF-B and HBV-DNA load was not significant（X²=3.118，P=0.538）：>10⁶ IU/mL，21.3%（10/47）；10⁵ IU/mL，16.7%（12/72）；10⁴ IU/mL，19.0%（12/63）；10³ IU/mL，10.7%（6/56）；and ＜10³ IU/mL，13.5%（14/104）. Conclusions Preoperative HBV-DNA load level does not appear to be related to the incidence of PHLF at Child-Pugh level B or above. This suggests that simple antiviral treatment can be started as soon as possible after surgery in hepatocellular carcinoma patients with Child-Pugh A liver function.

Key words: Liver neoplasm, Hepatectomy, HBV-DNA load, Posthepatectomy liver failure