Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis
Abstract Background To determine the standard remnant liver volume (SRLV) threshold to avoid postoperative hepatic insufficiency inpatients in different stages of hepatic fibrosis who undergo right hemi-hepatectomy. Methods Data for 85 patients at our single medical center were analysed prospectivel...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-021-01065-x |
| _version_ | 1818598641233821696 |
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| author | Zhiming Zhang Gaoxiong Ouyang Peng Wang Yuan Ren Yukai Liu Jun Chen Yumei Zhang Jianyong Liu Lequn Li |
| author_facet | Zhiming Zhang Gaoxiong Ouyang Peng Wang Yuan Ren Yukai Liu Jun Chen Yumei Zhang Jianyong Liu Lequn Li |
| author_sort | Zhiming Zhang |
| collection | DOAJ |
| description | Abstract Background To determine the standard remnant liver volume (SRLV) threshold to avoid postoperative hepatic insufficiency inpatients in different stages of hepatic fibrosis who undergo right hemi-hepatectomy. Methods Data for 85 patients at our single medical center were analysed prospectively to examine whether the following factors differed significantly between those who experienced postoperative hepatic insufficiency and those who did not: height, prothrombin time, remnant liver volume, SRLV or hepatic fibrosis stage. Results Logistic regression showed SRLV and hepatic fibrosis stage to be independent risk factors for postoperative hepatic insufficiency. The threshold SRLV for predicting insufficiency was 203.2 ml/m2 across all patients [area under receiver operating characteristic curve (AUC) 0.778, sensitivity 66.67%, specificity 83.64%, p<0.0001), 193.8 ml/m2 for patients with severe hepatic fibrosis (AUC 0.938, sensitivity 91.30%, specificity 85.71%, p<0.0001), and 224.3 ml/m2 for patients with cirrhosis (AUC 0.888, sensitivity 100%, specificity 64.29%, p<0.0001). Conclusions Right hemi-hepatectomy may be safer in Chinese patients when the standard remnant liver volume is more than 203.2 ml/m2 in the absence of hepatic fibrosis or cirrhosis, 193.8 ml/m2 in the presence of severe hepatic fibrosis or 224.3 ml/m2 in the presence of cirrhosis. |
| first_indexed | 2024-12-16T12:06:55Z |
| format | Article |
| id | doaj.art-c965587acc6d48de945c98c17b72d7c1 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-16T12:06:55Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-c965587acc6d48de945c98c17b72d7c12022-12-21T22:32:17ZengBMCBMC Surgery1471-24822021-01-012111910.1186/s12893-021-01065-xSafe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosisZhiming Zhang0Gaoxiong Ouyang1Peng Wang2Yuan Ren3Yukai Liu4Jun Chen5Yumei Zhang6Jianyong Liu7Lequn Li8Department of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Radiology, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Pathology, Guangxi Medical University Cancer HospitalDepartment of Chemotherapy, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalAbstract Background To determine the standard remnant liver volume (SRLV) threshold to avoid postoperative hepatic insufficiency inpatients in different stages of hepatic fibrosis who undergo right hemi-hepatectomy. Methods Data for 85 patients at our single medical center were analysed prospectively to examine whether the following factors differed significantly between those who experienced postoperative hepatic insufficiency and those who did not: height, prothrombin time, remnant liver volume, SRLV or hepatic fibrosis stage. Results Logistic regression showed SRLV and hepatic fibrosis stage to be independent risk factors for postoperative hepatic insufficiency. The threshold SRLV for predicting insufficiency was 203.2 ml/m2 across all patients [area under receiver operating characteristic curve (AUC) 0.778, sensitivity 66.67%, specificity 83.64%, p<0.0001), 193.8 ml/m2 for patients with severe hepatic fibrosis (AUC 0.938, sensitivity 91.30%, specificity 85.71%, p<0.0001), and 224.3 ml/m2 for patients with cirrhosis (AUC 0.888, sensitivity 100%, specificity 64.29%, p<0.0001). Conclusions Right hemi-hepatectomy may be safer in Chinese patients when the standard remnant liver volume is more than 203.2 ml/m2 in the absence of hepatic fibrosis or cirrhosis, 193.8 ml/m2 in the presence of severe hepatic fibrosis or 224.3 ml/m2 in the presence of cirrhosis.https://doi.org/10.1186/s12893-021-01065-xStandard remnant liver volumeHepatectomyHCCHepatic fibrosisCirrhosis |
| spellingShingle | Zhiming Zhang Gaoxiong Ouyang Peng Wang Yuan Ren Yukai Liu Jun Chen Yumei Zhang Jianyong Liu Lequn Li Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis BMC Surgery Standard remnant liver volume Hepatectomy HCC Hepatic fibrosis Cirrhosis |
| title | Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis |
| title_full | Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis |
| title_fullStr | Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis |
| title_full_unstemmed | Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis |
| title_short | Safe standard remnant liver volume after hepatectomy in HCC patients in different stages of hepatic fibrosis |
| title_sort | safe standard remnant liver volume after hepatectomy in hcc patients in different stages of hepatic fibrosis |
| topic | Standard remnant liver volume Hepatectomy HCC Hepatic fibrosis Cirrhosis |
| url | https://doi.org/10.1186/s12893-021-01065-x |
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