The effect of overweight status on the short-term and 20-y outcomes after hepatic resection in patients with hepatocellular carcinoma

Background: We aimed to evaluate the impact of body mass index (BMI) on the short- and long-term outcomes of hepatic resection in patients with hepatocellular carcinoma (HCC). Methods: We performed 371 hepatic resections in HCC patients whom we categorized into two groups based on BMI: BMI ≥25 (n = 77) and BMI <25 (n = 294). We compared surgical outcomes between groups. Results: The incidence of postoperative complications in the BMI ≥25 group was comparable to those in the BMI <25 group. However, patients in the BMI <25 group showed a significantly worse long-term prognosis than those in the BMI ≥25 group (P < 0.01). The results of multivariate analyses showed that BMI <25 was an independent and prognostic indicator of long-term outcome after hepatic resection in HCC patients. Conclusions: A BMI ≥25 is not a risk factor for mortality or postoperative complications, and is considered to provide a better long-term prognosis (>20 y) than a BMI <25 in patients with HCC after hepatic resection. Further studies are needed to determine whether these results apply to other patient populations outside Japan where BMI ≥30 is more prevalent.