{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:13:56Z","timestamp":1790295236856,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T00:00:00Z","timestamp":1637452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Few reported studies examine the relationship between zinc (Zn) deficiency and short\u2010 and long\u2010term outcomes in patients with hepatocellular carcinoma undergoing hepatic resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed data from 179 consecutive patients who had undergone curative hepatic resection for hepatocellular carcinoma in our institute between January 2016 and May 2019. Zn deficiency was defined in accordance with the Japanese Society of Clinical Nutrition guidelines. We allocated the participants into two groups according to Zn deficiency status, and analyzed the clinicopathological and short\u2010 and long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this series, 32 patients (17.8%) had Zn deficiency. Zn deficiency was significantly associated with older age, lower serum albumin, higher aspartate aminotransferase, lower hemoglobin, higher creatinine, lower prognostic nutritional index, higher liver fibrosis markers, albumin\u2010bilirubin\u00a02, portal hypertension, larger amount of estimated blood loss, larger amount of maximum ascites, longer hospital stay, postoperative complications, and liver\u2010related complications. Concentrations of liver fibrosis markers were negatively correlated with serum Zn concentrations. Zn deficiency, albumin\u2010bilirubin\u00a02, and non\u2010laparoscopic approach were identified as independent predictors of postoperative complications. Multivariate analyses revealed that the overall survival rate decreased in parallel with decreasing Zn concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, Zn deficiency was significantly associated with poorer liver function, more severe liver fibrosis, higher incidence of postoperative complications, and worse overall survival according to multivariate analysis. Serum Zn status could serve as a new surrogate marker for predicting short\u2010 and long\u2010term outcomes in patients undergoing hepatic resection for hepatocellular carcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13730","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T06:17:37Z","timestamp":1636611457000},"page":"210-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Significance of zinc deficiency in patients with hepatocellular carcinoma undergoing hepatic resection"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8085-2857","authenticated-orcid":false,"given":"Norifumi","family":"Harimoto","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5438-4551","authenticated-orcid":false,"given":"Kenichiro","family":"Araki","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Muranushi","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouki","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiro","family":"Ishii","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Tsukagoshi","sequence":"additional","affiliation":[{"name":"Department of Innovative Cancer Immunotherapy Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Shirabe","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of General Surgery Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000515304"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.04.061"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.01.035"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.06.012"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.9151"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6672-6"},{"key":"e_1_2_8_9_1","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients (in Japanese)","volume":"85","author":"Onodera T","year":"1984","journal-title":"Nippon Geka Gakkai Zasshi"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-015-3613-0"},{"key":"e_1_2_8_11_1","first-page":"120","article-title":"Practice guideline for zinc deficiency","volume":"40","author":"Kodama H","year":"2018","journal-title":"J Jpn Soc Clin Nutr"},{"key":"e_1_2_8_12_1","first-page":"93","article-title":"Zinc: an overview","volume":"11","author":"Prasad AS","year":"1995","journal-title":"Nutrition"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.1998.tb01656.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3786-3"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.12.002"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007122"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.08.002"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1365-182X(17)30755-4"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-008-0588-6"},{"key":"e_1_2_8_21_1","first-page":"34","volume-title":"General rules for the clinical and pathological study of primary liver cancer","author":"Liver Cancer Study Group of Japan","year":"2003"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510240201"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/137.5.1345"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(67)91031-8"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1535370214558026"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-2797(03)00087-5"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13708"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-017-1425-z"},{"issue":"6","key":"e_1_2_8_29_1","first-page":"822","article-title":"Correlation of immune and nutritional status with wound complications in patients undergoing vascular operations","volume":"93","author":"Casey J","year":"1983","journal-title":"Surgery"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/0261-5614(90)90008-G"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(98)00036-7"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1998.10718787"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.2353\/ajpath.2008.070631"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13412"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.405"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.14437"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.3164\/jcbn.19-98"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13601"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.110983"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-021-02675-5"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2014.04.018"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.13730","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hepr.13730","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.13730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T04:39:23Z","timestamp":1693197563000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hepr.13730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,21]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1111\/hepr.13730"],"URL":"https:\/\/doi.org\/10.1111\/hepr.13730","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,21]]},"assertion":[{"value":"2021-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}