Prognostic Impact of the Preoperative Habitual Alcohol Consumption in Patients Undergoing Surgical Resection for Hepatocellular Carcinoma

BACKGROUND: Recent dynamic changes in the etiology of hepatocellular carcinoma (HCC) have provoked an active discussion on the prognostic factors and better management of HCC patients undergoing surgery, considering the underlying metabolic factors However, little is known about the influence of preoperative habitual alcohol consumption on the clinical outcomes of HCC. METHODS: We investigated the prognostic impact of preoperative alcohol consumption and the etiology of HCC in 1223 patients who underwent surgery for HCC. RESULTS: Multivariate analysis identified the tumor etiology as being significantly associated with the overall survival, and the preoperative average alcohol consumption as being significantly associated with the recurrence-free survival rate after surgery (hazard ratio [HR], 1.02; 95% CI, 1.00-1.03 per +10 g/day). Hazard estimation also revealed an increased risk of recurrence with increasing preoperative average alcohol consumption, irrespective of the etiology of HCC. Competing-risks regression analysis confirmed that the higher the preoperative average alcohol consumption, the shorter the time-to-interventional failure (HR, 1.03; 95% CI, 1.01-1.05 per +10 g/day) and the worse the disease-specific survival (HR, 1.03; 95% CI, 1.00-1.05 per +10 g/day). CONCLUSION: The present analysis suggests that preoperative average alcohol consumption is correlated with the oncological outcomes in patients undergoing surgery for HCC, irrespective of the etiology of HCC.