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

Shioiri, Takayuki; Ishizuka, Mitsuru; Kato, Masato; Aoki, Taku; Kubota, Keiichi

doi:10.1159/000447131

Cited by 7 publications

(2 citation statements)

References 28 publications

(46 reference statements)

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“…For easier application to the prediction model, most continuous variables were converted to categories while performing the multivariable logistic regression analysis: advanced age (≥65 years), body mass index (>30 kg/m 2 ), platelet count (<150×10 9 l −1 ), 8 PT-INR (>1.10), total bilirubin (>1.2 mg dl −1 ), AST (>39 U l −1 ), ALT (>45 U l −1 ), albumin (>3.8 mg l −1 ), ALBI score (>−2.28), 9 hyaluronic acid (>200 ng ml −1 ), 27 ICGR15 (>15%), ICG-Krem (<0.10), 6 tumour diameter (>50 mm), intraoperative blood loss (>860 ml), 28 LSM value (>5.3 kPa), 11 PDFF value (>5%), 29 R2* value (>60 s −1 ).…”

Section: Methodsmentioning

confidence: 99%

A proposed model on MR elastography for predicting postoperative major complications in patients with hepatocellular carcinoma

et al. 2021

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Objective: To develop a model for predicting post-operative major complications in patients with hepatocellular carcinoma (HCC). Methods: In all, 186 consecutive patients with pre-operative MR elastography were included. Complications were categorised using Clavien‒Dindo classification, with major complications defined as ≥Grade 3. Liver-stiffness measurement (LSM) values were measured on elastogram. The indocyanine green clearance rate of liver remnant (ICG-Krem) was based on the results of CT volumetry, intraoperative data, and ICG-K value. For an easy application to the prediction model, the continuous variables were converted to categories. Moreover, logistic regression analysis and fivefold cross-validation were performed. The prediction model’s discriminative performance was evaluated using the area under the receiver operating characteristic curve (AUC), and the calibration of the model was assessed by the Hosmer‒Lemeshow test. Results: 43 of 186 patients (23.1%) had major complications. The multivariate analysis demonstrated that LSM, albumin–bilirubin (ALBI) score, intraoperative blood loss, and ICG-Krem were significantly associated with major complications. The median AUC of the five validation subsets was 0.878. The Hosmer-Lemeshow test confirmed no evidence of inadequate fit (p = 0.13, 0.19, 0.59, 0.59, and 0.73) on the fivefold cross-validation. The prediction model for major complications was as follows: −2.876 + 2.912 [LSM (>5.3 kPa)]+1.538 [ALBI score (>−2.28)]+0.531 [Intraoperative blood loss (>860 ml)]+0.257 [ICG-Krem (<0.10)]. Conclusion: The proposed prediction model can be used to predict post-operative major complications in patients with HCC. Advances in knowledge: The proposed prediction model can be used in routine clinical practice to identify post-operative major complications in patients with HCC and to strategise appropriate treatments of HCC.

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Section: Methodsmentioning

confidence: 99%

A proposed model on MR elastography for predicting postoperative major complications in patients with hepatocellular carcinoma

et al. 2021

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“…The incidence of liver cancer in China accounts for third place malignant tumors, and there has been an increasing trend in its incidence in recent years[1,2]. In clinical practice, the best treatment for early liver cancer is the surgical resection of lesions.…”

Section: Introductionmentioning

confidence: 99%

Observation of the effect of targeted therapy of 64-slice spiral CT combined with cryoablation for liver cancer

Yan¹,

Xu²,

Shen³

et al. 2017

WJG

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AIMTo observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer.METHODSA total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group (n = 56, 65 tumors) and 64-slice group (n = 8, 77 tumors). All patients were accepted and received targeted therapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion (HAP), portal vein perfusion (PVP), and the hepatic arterial perfusion index (HAPI)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding.RESULTSGuided scan times in the dual-slice group was longer than that in the 64-slice group (t = 11.445, P = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group (81.58%) was lower than that in the 64-slice group (92.86%) (χ2 = 5.707, P = 0.017). The HAP and HAPI of tumor tissues were lower at four weeks post-treatment than at pre-treatment in both groups (all P < 0.05), and those in the 64-slice group were lower than that in the dual-slice group (all P < 0.05). HAP and PVP were lower and HAPI was higher in tumor adjacent tissues at post-treatment than at pre-treatment (all P < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment (all P < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group (all P < 0.05).CONCLUSION64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used.

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Use of the National Clinical Database to evaluate the association between preoperative liver function and postoperative complications among patients undergoing hepatectomy

Kubota

Aoki

Kumamaru

et al. 2019

J Hepato Biliary Pancreat

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BackgroundThe aim of the present study was to clarify the association between preoperative liver function and complications after hepatectomy.MethodsThe study included 11,686 patients registered in the National Clinical Database for 2015 for whom data on indocyanine green at 15 min (ICG15) and hepatectomy were available. The patients were divided into four groups: group A (ICG15 <10%; n = 5,661), group B (ICG15 10% to <20%; n = 4,381), group C (ICG15 20% to <30%; n = 1,173) and group D (ICG15 >30%; n = 463). Hepatectomy procedures were classified as partial resection (n = 3,934), systematic subsegmentectomy (n = 2,055), monosectionectomy (n = 2,043), bisectionectomy (n = 2,993) and trisectionectomy (n = 208). Complications were classified using the Clavien‐Dindo classification (CD) and evaluated by ICG15 category and procedure type.ResultsComplications more severe than CD III increased significantly as the operation time lengthened and the intraoperative bleeding volume increased (P < 0.001). ICG15 category was positively associated with operative death, >CD III complications, surgical site infection (SSI), liver failure, and intractable ascites for many of the major hepatectomy procedures, but not with bile leakage. More complications were observed in patients outside the Makuuchi criteria than in those within the criteria.ConclusionsOperation time and intraoperative bleeding volume are significantly associated with severe postoperative complications in patients undergoing hepatectomy. ICG15 is a good indicator predictive of operative death, >CD III complications, SSI, liver failure and intractable ascites.

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

Cited by 7 publications

References 28 publications

A proposed model on MR elastography for predicting postoperative major complications in patients with hepatocellular carcinoma

A proposed model on MR elastography for predicting postoperative major complications in patients with hepatocellular carcinoma

Observation of the effect of targeted therapy of 64-slice spiral CT combined with cryoablation for liver cancer

Use of the National Clinical Database to evaluate the association between preoperative liver function and postoperative complications among patients undergoing hepatectomy

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