Liver failure after hepatocellular carcinoma surgery

Motoyama, Hiroaki; Kobayashi, Adam; Yokoyama, Tetsuji; Shimizu, Akira; Furusawa, Norihiko; Sakai, Hiroshi; Kitagawa, Noriyuki; Ohkubo, Yohei; Tsukahara, Teruomi; Miyagawa, Shinichi

doi:10.1007/s00423-014-1252-0

Cited by 13 publications

(9 citation statements)

References 51 publications

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“…Among others, reports by Nanashima et al4344 and Motoyama et al36 suggested that elevated preoperative prothrombin time (>70–80% of normal ranges) independently predicted PHLF.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, other studies by Li et al 34 and Shen et al 35 reported that a preoperative serum bilirubin level of ≥1.19 mg/dL was a significant independent risk factor for PHLF in patients undergoing liver resection. Motoyama et al 36 also reported a significant correlation between preoperative serum bilirubin and PHLF using the ISGLS criteria and developed a model for prediction of PHLF incorporating serum bilirubin, INR and the presence of intra-operative packed red blood cell transfusion. This model provide stronger correlation with PHLF when compared with MELD score and ICG R15 .…”

Section: Discussionmentioning

confidence: 99%

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Predictors of post-hepatectomy liver failure in patients undergoing extensive liver resections for hepatocellular carcinoma

Chin

Allen

Teo

et al. 2018

Ann Hepatobiliary Pancreat Surg

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Backgrounds/AimsTo determine the prevalence of post-hepatectomy liver failure/insufficiency (PHLF/I) in patients undergoing extensive hepatic resections for hepatocellular carcinoma (HCC) and to assess the predictive value of preoperative factors for post-hepatectomy liver failure or insufficiency (PHLF/I).MethodsA retrospective review of patients who underwent liver resections for HCC between 2001 and 2013 was conducted. Preoperative parameters were assessed and analyzed for their predictive value of PHLF/I. Definitions used included the 50–50, International Study Group of Liver Surgery (ISGLS) and Memorial Sloan Kettering Cancer Centre (MSKCC) criteria.ResultsAmong the 848 patients who underwent liver resections for HCC between 2001 and 2013, 157 underwent right hepatectomy (RH) and extended right hepatectomy (ERH). The prevalence of PHLF/I was 7%, 41% and 28% based on the 50–50, ISGLS and MSKCC criteria, respectively. There were no significant differences in PHLF/I between RH and ERH. Model for End-Stage Liver Disease (MELD) score and bilirubin were the strongest independent predictors of PHLF/I based on the 50–50 and ISGLS/MSKCC criteria, respectively. Predictive models were developed for each of the criteria with multiple logistic regression.ConclusionsMELD score, bilirubin, alpha-fetoprotein and platelet count showed significant predictive value for PHLF/I (all p<0.05). A composite score based on these factors serves as guideline for physicians to better select patients undergoing extensive resections to minimize PHLF.

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“…Among others, reports by Nanashima et al4344 and Motoyama et al36 suggested that elevated preoperative prothrombin time (>70–80% of normal ranges) independently predicted PHLF.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Predictors of post-hepatectomy liver failure in patients undergoing extensive liver resections for hepatocellular carcinoma

Chin

Allen

Teo

et al. 2018

Ann Hepatobiliary Pancreat Surg

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“…Operation resection is still the preferred treatment for early HCC [1]. However, HCC patients after surgery have decreased immune function, damaged liver function, metastasis, and recurrence [2][3][4]. It has been reported that HCC can be treated by transcatheter arterial chemoembolization (TACE) via superselective segmental embolization [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of Transcatheter Arterial Chemoembolization Combined with Argon–Helium Cryosurgery System on the Changes of NK Cells and T Cell Subsets in Peripheral Blood of Hepatocellular Carcinoma Patients

Huang¹,

Wang²,

Huang³

2015

Cell Biochem Biophys

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Hepatocellular carcinoma (HCC) is one of the most aggressive tumors in humans. T lymphocytes and natural killer (NK) cells are the body's first line of defense to prevent tumor cell growth. Previous studies have demonstrated that transcatheter arterial chemoembolization (TACE) combined with argon-helium cryosurgery system (AHCS) can effectively treat liver cancer. However, the mechanism of the treatment is unclear yet. In the current study, we investigated the effects of TACE combined with AHCS on the changes of T cell subsets and NK cells in peripheral blood of HCC. Our data show that alpha-fetoprotein (AFP) levels in peripheral blood were significantly up-regulated in HCC patients before treatment when compared with healthy people and reduced after TACE combined with AHCS treatment (P < 0.01). In addition, we found that CD4+ cells and NK cells decreased (P < 0.05) and CD8+ cells increased (P < 0.05) in HCC patients when compared with healthy people. After treatment, the CD4+ cells, CD4+/CD8+ ratio, and NK cells were dramatically increased in HCC patients (P < 0.05). In contrast, CD8+ cells were significantly decreased (P < 0.05). TACE combined with AHCS treatment significantly prolonged 1-year survival rate of HCC patients and did not show significant side effects. Taken together, our data indicate that TACE combined with AHCS treatment improves patients' immune system. It is a feasible and effective therapeutic method for HCC patients.

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“…The Model for End-stage Liver Disease (MELD) was initially constructed as a predictor of mortality following transjugular intrahepatic portosystemic shunts (TIPS) and has been adopted as a measure of liver dysfunction for transplantation(21, 22). Preoperative MELD score has been identified as a predictor of PHLI, but it is limited in sensitivity and specificity, particularly when applied to patients without cirrhosis(6, 23–25). Postoperative parameters, such as the 50–50 criteria which uses prothrombin time <50% and bilirubin >50 µmol/L on postoperative day five as significant predictors of mortality, have also been used to predict PHLI but are not helpful for identifying high-risk patients prior to operation(2, 26).…”

Section: Introductionmentioning

confidence: 99%

Quantitative Imaging Features and Postoperative Hepatic Insufficiency: A Multi-Institutional Expanded Cohort

Pak

Chakraborty

Gönen

et al. 2018

Journal of the American College of Surgeons

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Liver failure after hepatocellular carcinoma surgery

Abstract: The developed model could be useful for predicting the occurrence of PHLF in HCC patients with underlying liver disease.

Cited by 13 publications

References 51 publications

Predictors of post-hepatectomy liver failure in patients undergoing extensive liver resections for hepatocellular carcinoma

Predictors of post-hepatectomy liver failure in patients undergoing extensive liver resections for hepatocellular carcinoma

Effect of Transcatheter Arterial Chemoembolization Combined with Argon–Helium Cryosurgery System on the Changes of NK Cells and T Cell Subsets in Peripheral Blood of Hepatocellular Carcinoma Patients

Quantitative Imaging Features and Postoperative Hepatic Insufficiency: A Multi-Institutional Expanded Cohort

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