Perioperative change in white blood cell count predicts outcome of hepatic resection for hepatocellular carcinoma

In spite of improvements in surgical management, hepatocellular carcinoma (HCC) still recurs after operation in 60-70% of patients. Therefore, we investigated the relation between perioperative change in white blood cell count (WBC) and tumor recurrence as well as survival in patients with HCC after hepatic resection. Subjects were 53 patients who underwent elective hepatic resection for HCC. We retrospectively examined the relation between perioperative change in WBC and recurrence of HCC as well as overall survival. Advanced tumor stage and increasing of WBC on postoperative day (POD) 1 were positively associated with worse disease-free survival rate on both univariate and multivariate analysis (P < 0.05). Advanced tumor stage, increasing of WBC on POD 1, and blood transfusion were positively associated with worse overall survival rate on univariate analysis (P < 0.05), while change in WBC was the only independent factor on multivariate analysis (P < 0.05). Perioperative change in WBC after elective hepatic resection for HCC is positively associated with recurrence and worse survival.