Underweight Patients Show an Increased Rate of Postoperative Death After Surgery for Hepatocellular Carcinoma

Objective: To evaluate the influence of body mass index (BMI) on postoperative death in patients undergoing surgery for HCC. Methods: Three hundred forty-two patients were enrolled, and divided into three groups: Group A, BMI < 22.5; Group B, BMI >= 22.5 to < 25; Group C, BMI >= 25. Univariate and multivariate analyses of postoperative death were performed to compare BMI with clinical factors. Kaplan-Meier analysis and log rank test were used to compare such outcome in Groups A, B, and C. Results: Kaplan-Meier analysis and log rank test revealed that Group A had a higher rate of postoperative death than Group B or C (P = 0.010). Univariate and multivariate analyses selected being underweight (Group B, C/Group A) (odds ratio, 1.829; 95% C.I., 1.091-3.068; P = 0.022) as one of the factors predictive of postoperative death, together with aspartate aminotransferase level (P = 0.042) and HCC growth pattern (P = 0.032). Conclusions: BMI is a simple but important predictor of postoperative death in patients undergoing surgery for HCC, and is able to classify such patients into three independent groups. J. Surg. Oncol. 2011;104:809-813. (C) 2011 Wiley Periodicals, Inc.