Efficacy and safety of hepatectomy in hepatitis B-related hepatocellular carcinoma with compensated versus recompensated cirrhosis: A propensity score matching study.

Wu, Nijin; Zhang, Can; Liu, Qiqi; Cao, Huiling; Zhang, Yu; Leng, Xinyu; Yu, Hongli; Liu, Siyuan et al. · Surgery · 2026

retrospective_cohort · Level III

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Abstract

The Baveno VII consensus recently defined recompensation in patients with decompensated cirrhosis. Whether hepatectomy is a viable option for recompensated patients remains uncertain. The purpose of this retrospective study was to evaluate the efficacy and safety of hepatectomy of hepatitis B-related hepatocellular carcinoma with recompensated cirrhosis. Clinical data of patients with hepatitis B-related hepatocellular carcinoma who underwent hepatectomies between January 2011 and December 2022 were collected. Patients with cirrhosis were stratified into compensated and recompensated cohorts. Propensity score matching was used to minimize the effect of potential selection bias on the results. Six hundred twenty-two patients with hepatitis B-related hepatocellular carcinoma complicated with compensated cirrhosis, and 81 patients complicated with recompensated cirrhosis were enrolled in this study. After propensity score matching, 80 hepatocellular carcinoma patients with recompensated cirrhosis and 80 patients with compensated cirrhosis were matched and analyzed. Postoperative liver decompensation was comparable between the compensated group and recompensated group (P = .828). In addition, the 90-day mortality (P = .620), posthepatectomy liver failure (P = .137), and major complications (not related to hepatic dysfunction) (P = .514) were comparable between the 2 groups. The 5-year overall survival rate in the compensated and recompensated groups was 65.5% and 56.1% (P = .357), respectively. The 5-year progression-free survival rate was 50.2% in patients with compensated cirrhosis and 35.5% in patients with recompensated cirrhosis (P = .426). The safety and efficacy of hepatectomy in hepatitis B-related hepatocellular carcinoma patients with compensated cirrhosis and recompensated cirrhosis are comparable; therefore, it represents a viable treatment option for these patients.