{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:33:20Z","timestamp":1763037200367,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Some patients who achieve a sustained virological response (SVR) to interferon (IFN) treatment for chronic hepatitis C prior to hepatic resection for hepatocellular carcinoma (HCC) experience postoperative recurrence. This study investigated the relationship between obesity and postoperative HCC recurrence in SVR patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010nine patients who had achieved SVR before hepatic resection were evaluated. Patients had a solitary tumor \u22645 cm in diameter or \u22643 lesions each \u22643 cm in size with no macroscopic vascular invasion (Milan criteria). Patient characteristics potentially associated with recurrence risk were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three\u2010, 5\u2010, and 7\u2010year recurrence\u2010free survival after surgery were 65%, 44%, and 41%, respectively. Univariate analysis showed that obesity (<jats:italic>P<\/jats:italic> &lt; .01), hypertension (<jats:italic>P<\/jats:italic> = .038), and non\u2010anatomical resection (<jats:italic>P<\/jats:italic> = .022) were significantly associated with a lower recurrence\u2010free survival rate. In a multivariate analysis, obesity (hazard ratio, 2.8; 95% confidence interval [CI] 1.3\u20106.1; <jats:italic>P<\/jats:italic> &lt; .01) and non\u2010anatomical resection (hazard ratio, 2.7; 95% CI 1.1\u20106.2; <jats:italic>P<\/jats:italic> = .025) were independently associated with postoperative recurrence. Three\u2010, 5\u2010, and 7\u2010year overall survival rates after surgery were 100%, 80%, and 64% in obese patients and 100%, 92%, and 82% in non\u2010obese patients, respectively (<jats:italic>P<\/jats:italic> = .014). However, other variables showed no significant difference in the overall survival rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Obesity and non\u2010anatomical resection were independent risk factors for HCC recurrence after hepatic resection and successful IFN therapy. Obesity is an important clinical problem to consider to improve postoperative outcomes in such patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.12183","type":"journal-article","created":{"date-parts":[[2018,6,23]],"date-time":"2018-06-23T04:58:58Z","timestamp":1529729938000},"page":"319-326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Obesity and recurrence\u2010free survival in patients with hepatocellular carcinoma after achieving sustained virological response to interferon therapy for chronic hepatitis C"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0164-2414","authenticated-orcid":false,"given":"Hiroji","family":"Shinkawa","sequence":"first","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka 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