Clinical Significance of Serum Antithrombin III Activity After Hepatectomy for Hepatocellular Carcinoma

Naruo Tokuyasu; Masataka Amisaki; Takehiko Hanaki; Yuki Murakami; Masaki Morimoto; Ei Uchinaka; Takuki Yagyu; Keisuke Goto; Tomoyuki Matsunaga; Manabu Yamamoto; Shuichi Takano; Teruhisa Sakamoto; Soichiro Honjo; Toshimichi Hasegawa; Yoshiyuki Fujiwara

doi:10.33160/yam.2021.05.007

Original Article

Clinical Significance of Serum Antithrombin III Activity After Hepatectomy for Hepatocellular Carcinoma

Naruo Tokuyasu, Masataka Amisaki, Takehiko Hanaki, Yuki Murakami, Masaki Morimoto, Ei Uchinaka, Takuki Yagyu, Keisuke Goto, Tomoyuki Matsunaga, Manabu Yamamoto, Shuichi Takano, Teruhisa Sakamoto, Soichiro Honjo, Toshimichi Hasegawa, Yoshiyuki Fujiwara

Author information

Naruo Tokuyasu
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Masataka Amisaki
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Takehiko Hanaki
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Yuki Murakami
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Masaki Morimoto
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Ei Uchinaka
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Takuki Yagyu
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Keisuke Goto
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Tomoyuki Matsunaga
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Manabu Yamamoto
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Shuichi Takano
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Teruhisa Sakamoto
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Soichiro Honjo
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Toshimichi Hasegawa
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Yoshiyuki Fujiwara
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan

Keywords: Antithrombin III, Hepatectomy, Hepatocellular carcinoma, Prognostic factor

JOURNAL FREE ACCESS

2021 Volume 64 Issue 2 Pages 168-175

DOI https://doi.org/10.33160/yam.2021.05.007

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Details

Abstract

Background As antithrombin III (AT-III) is produced in the hepatocytes, its serum activity decreases at the time of liver failure, in addition to ischemia reperfusion injury, vascular endothelial dysfunction, and disseminated intravascular coagulation (DIC). Here, we examined whether the serum AT-III value after hepatectomy could be a prognostic factor for hepatocellular carcinoma (HCC).

Methods Of 141 patients who underwent hepatectomy for HCC, data for 101 patients in whom serum AT-III activity was measured on the first postoperative day were extracted. Patients with serum AT-III activity > 50% and ≤ 50% were assigned to high value (72 cases) and low value (29 cases) groups, respectively. We examined the clinical and prognostic differences between these two groups.

Results The average age of enrolled patients (83 men and 18 women) was 68.0 years. The 5-year overall survival rate was 88% and 60% in the high and low value groups, respectively (P < 0.01). Furthermore, the 2-year relapse-free survival rate was 71% and 54% in the high and low value groups, respectively (P = 0.03).

Conclusion This is the first study to demonstrate that serum AT-III levels on the first postoperative day may serve as a prognostic factor in HCC patients.

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