Post-hepatectomy-related DIC Predicts Poor Survival After Resection for Colorectal Liver Metastases

Background/Aim: The prognostic significance of post-hepatectomy-related disseminated intravascular coagulation (DIC) in patients undergoing hepatic resection for colorectal liver metastases (CRLM) remains unclear. Patients and Methods: This single-center retrospective study included 89 patients who underwent hepatic resection for CRLM between December 2003 and March 2024. Post-hepatectomy-related DIC was defined as a revised Japanese Association for Acute Medicine DIC score of 3 or higher on postoperative day 3. Prognostic factors for overall and disease-free survival were analyzed using Cox proportional hazards regression models. Results: Post-hepatectomy-related DIC occurred in 29 patients (33%). Patients with post-hepatectomy-related DIC were more likely to undergo simultaneous colorectal and liver resection and anatomical hepatectomy, and had larger tumors, longer operative time, greater blood loss, and longer postoperative hospital stay. In multivariable analysis, carcinoembryonic antigen ≥20 ng/ml and post-hepatectomy-related DIC were independently associated with poorer overall survival, whereas lymph node metastasis and extrahepatic disease were independently associated with poorer disease-free survival. Conclusion: Post-hepatectomy-related DIC was an independent predictor of poorer overall survival after hepatic resection for CRLM and may be useful for postoperative risk stratification.