A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma.
<h4>Background & aim</h4>Hepatic resection is a treatment option for patients with hepatocellular carcinoma (HCC). However, factors associated with candidacy for resection and predictive of liver-related morbidity after resection for HCC remain unclear. This study aimed to assess can...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0241808 |
| _version_ | 1819124132589076480 |
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| author | Jonggi Choi So-Hyun Kim Seungbong Han Danbi Lee Ju Hyun Shim Young-Suk Lim Han Chu Lee Young-Hwa Chung Yung Sang Lee Sung-Gyu Lee Ki-Hun Kim Kang Mo Kim |
| author_facet | Jonggi Choi So-Hyun Kim Seungbong Han Danbi Lee Ju Hyun Shim Young-Suk Lim Han Chu Lee Young-Hwa Chung Yung Sang Lee Sung-Gyu Lee Ki-Hun Kim Kang Mo Kim |
| author_sort | Jonggi Choi |
| collection | DOAJ |
| description | <h4>Background & aim</h4>Hepatic resection is a treatment option for patients with hepatocellular carcinoma (HCC). However, factors associated with candidacy for resection and predictive of liver-related morbidity after resection for HCC remain unclear. This study aimed to assess candidacy for liver resection in patients with HCC and to design a model predictive of liver-related morbidity after resection.<h4>Methods</h4>A retrospective analysis of 1,565 patients who underwent liver resection for HCC between January 2016 and December 2017 was performed. The primary outcome was liver-related morbidity, including post-hepatectomy biochemical dysfunction (PHBD), ascites, hepatic encephalopathy, rescue liver transplantation, and death from any cause within 90 days. PHBD was defined as international normalized ratio (INR) > 1.5 or hyperbilirubinemia (> 2.9 mg/dL) on postoperative day ≥ 5.<h4>Results</h4>The 1,565 patients included 1,258 (80.4%) males and 307 (19.6%) females with a mean age of 58.3 years. Of these patients, 646 (41.3%) and 919 (58.7%) patients underwent major and minor liver resection, respectively. Liver-related morbidity was observed in 133 (8.5%) patients, including 77 and 56 patients who underwent major and minor resection, respectively. A total of 83 (5.3%) patients developed PHBD. Multivariate analysis identified cut-off values of the platelet count, serum albumin concentration, and ICG R15 value for predicting liver-related morbidity after resection. A model predicting postoperative liver-related morbidity was developed, which included seven factors: male sex, age ≥ 55 years, ICG R15 value ≥ 15%, major resection, platelet count < 150,000/mm3, serum albumin concentration < 3.5 g/dL, and INR > 1.1.<h4>Conclusion</h4>Hepatic resection for HCC was safe with 90-day liver-related morbidity and mortality rates of 8.5% and 0.8%, respectively. The developed point-based scoring system with seven factors could allow the prediction of the risk of liver-related morbidity after resection for HCC. |
| first_indexed | 2024-12-22T07:19:23Z |
| format | Article |
| id | doaj.art-9dcd2b01d4534cf2928ccc38ab92e4a7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T07:19:23Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-9dcd2b01d4534cf2928ccc38ab92e4a72022-12-21T18:34:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011511e024180810.1371/journal.pone.0241808A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma.Jonggi ChoiSo-Hyun KimSeungbong HanDanbi LeeJu Hyun ShimYoung-Suk LimHan Chu LeeYoung-Hwa ChungYung Sang LeeSung-Gyu LeeKi-Hun KimKang Mo Kim<h4>Background & aim</h4>Hepatic resection is a treatment option for patients with hepatocellular carcinoma (HCC). However, factors associated with candidacy for resection and predictive of liver-related morbidity after resection for HCC remain unclear. This study aimed to assess candidacy for liver resection in patients with HCC and to design a model predictive of liver-related morbidity after resection.<h4>Methods</h4>A retrospective analysis of 1,565 patients who underwent liver resection for HCC between January 2016 and December 2017 was performed. The primary outcome was liver-related morbidity, including post-hepatectomy biochemical dysfunction (PHBD), ascites, hepatic encephalopathy, rescue liver transplantation, and death from any cause within 90 days. PHBD was defined as international normalized ratio (INR) > 1.5 or hyperbilirubinemia (> 2.9 mg/dL) on postoperative day ≥ 5.<h4>Results</h4>The 1,565 patients included 1,258 (80.4%) males and 307 (19.6%) females with a mean age of 58.3 years. Of these patients, 646 (41.3%) and 919 (58.7%) patients underwent major and minor liver resection, respectively. Liver-related morbidity was observed in 133 (8.5%) patients, including 77 and 56 patients who underwent major and minor resection, respectively. A total of 83 (5.3%) patients developed PHBD. Multivariate analysis identified cut-off values of the platelet count, serum albumin concentration, and ICG R15 value for predicting liver-related morbidity after resection. A model predicting postoperative liver-related morbidity was developed, which included seven factors: male sex, age ≥ 55 years, ICG R15 value ≥ 15%, major resection, platelet count < 150,000/mm3, serum albumin concentration < 3.5 g/dL, and INR > 1.1.<h4>Conclusion</h4>Hepatic resection for HCC was safe with 90-day liver-related morbidity and mortality rates of 8.5% and 0.8%, respectively. The developed point-based scoring system with seven factors could allow the prediction of the risk of liver-related morbidity after resection for HCC.https://doi.org/10.1371/journal.pone.0241808 |
| spellingShingle | Jonggi Choi So-Hyun Kim Seungbong Han Danbi Lee Ju Hyun Shim Young-Suk Lim Han Chu Lee Young-Hwa Chung Yung Sang Lee Sung-Gyu Lee Ki-Hun Kim Kang Mo Kim A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma. PLoS ONE |
| title | A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma. |
| title_full | A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma. |
| title_fullStr | A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma. |
| title_full_unstemmed | A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma. |
| title_short | A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma. |
| title_sort | simple and clinically applicable model to predict liver related morbidity after hepatic resection for hepatocellular carcinoma |
| url | https://doi.org/10.1371/journal.pone.0241808 |
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