A New Prediction Model of Postoperative Complications after Major Hepatectomy for Hepatocellular Carcinoma

Abstract

Background/Aims: Serum hyaluronic acid (HA) concentrations reflect the degree of hepatic dysfunction and may have potential for predicting postoperative complications in a major hepatectomy for hepatocellular carcinoma (HCC). Methods: Serum HA concentrations and other conventional liver function tests were measured prior to major hepatectomies in 52 patients. Independent predictors for postoperative complications were analyzed and the discriminant equation was established and validated. Results: Postoperative complications occurred in 17 patients. Serum HA concentrations and the estimated remnant liver volume ratio (remnantVol%) were recognized as independent predictors for postoperative complications (OR 1.03, 0.85; CI 95% 1.01–1.06, 0.76–0.95; p = 0.006, 0.006; respectively) and produced the discriminant equation: logit = 4.15 + 0.03 × (HA) –0.16 × (remnantVol%). The value of the area under the curve of a receiver operating characteristic analysis was 0.92. If the cut-off of the logit value was set to 0, then the predictive accuracy was 0.88. The validation accuracy performed by a leave-one-out cross-validation method was 0.83. Conclusions: The constructed discriminant equation model consisting of the preoperative serum HA concentrations and estimated remnantVol% could be useful for predicting postoperative complications in a major hepatectomy for HCC.

Prediction model for 30-day morbidity after gynecological malignancy surgery

“…Several prediction models for postoperative morbidity in general surgery, cardiac surgery, and hepatocellular carcinoma populations have been introduced [8,9,13]. However, the aforementioned models cannot reliably be used in gynecological oncology [21,23,24].…”

“…Several prediction models using the identified risk factors have been suggested to forecast the occurrence of postoperative morbidity in general surgery [8–10], cardiac surgery [11], esophageal cancer surgery [12], and hepatocelluar cancer surgery [13]. However, the individualized prediction models for morbidity after gynecologic cancer surgery are relatively rare [14,15].…”

Hypointense hepatocellular carcinomas on apparent diffusion coefficient mapping: Pathological features and metastatic recurrence after hepatectomy

“…At our institution, anatomical resections were basically planned for HCC if the liver function was well preserved and the estimated remnant liver volume met our previously established criteria . The indications for hepatectomy were evaluated according to the extent of tumor progression, liver function and general condition of the patient.…”

Hyaluronic Acid Predicts Postoperative Large Amount of Ascites after Liver Resection for Patients with Hepatocellular Carcinoma

“…An excess infusion volume, splenectomy and lymphatic leakage from the resected surfaces of the liver or hepatic ligament may also be risk factors for PLA. Although recent studies have demonstrated that an elevated serum level of hyaluronic acid (HA) can predict complications after LR for patients with HCC [8] , there is no study that has reported that HA is closely associated with PLA. In addition, few studies investigated whether PLA is a useful prognostic factor in HCC patients undergoing LR.…”