A novel model for predicting posthepatectomy liver failure based on liver function and degree of liver resection in patients with hepatocellular carcinoma

HPB Volume 23 Issue 1 Page 134-143 published_at 2021-01
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Title ( eng )
A novel model for predicting posthepatectomy liver failure based on liver function and degree of liver resection in patients with hepatocellular carcinoma
Creator
Honmyo Naruhiko
Oshita Akihiko
Onoe Takashi
Kohashi Toshihiko
Fukuda Saburo
Ohmori Ichiro
Abe Tomoyuki
Imaoka Yasuhiro
Source Title
HPB
Volume 23
Issue 1
Start Page 134
End Page 143
Abstract
Background
The permissible liver resection rate for preventing posthepatectomy liver failure (PHLF) remains unclear. We aimed to develop a novel PHLF-predicting model and to strategize hepatectomy for hepatocellular carcinoma (HCC).

Methods
This retrospective study included 335 HCC patients who underwent anatomical hepatectomy at eight institutions between 2013 and 2017. Risk factors, including volume-associated liver-estimating parameters, for PHLF grade B–C were analyzed in a training set (n = 122) via multivariate analysis, and a PHLF prediction model was developed. The utility of the model was evaluated in a validation set (n = 213).

Results
Our model was based on the three independent risk factors for PHLF identified in the training set: volume-associated indocyanine green retention rate at 15 min, platelet count, and prothrombin time index (the VIPP score). The areas under the receiver operating characteristic curve of the VIPP scores for severe PHLF in the training and validation sets were 0.864 and 0.794, respectively. In both sets, the VIPP score stratified patients at risk for severe PHLF, with a score of 3 (specificity, 0.92) indicating higher risk.

Conclusion
Our model facilitates the selection of the appropriate hepatectomy procedure by providing permissible liver resection rates based on VIPP scores.
Descriptions
This research was supported by the Japan Agency for Medical Research and Development (AMED, grant number JP19fk0210051) and the Japanese Society for the Promotion of Science (JSPS KAKENHI, grant number JP18K08706)
Language
eng
Resource Type journal article
Publisher
Elsevier
Date of Issued 2021-01
Rights
© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
This is not the published version. Please cite only the published version. この論文は出版社版ではありません。引用の際には出版社版をご確認、ご利用ください。
Publish Type Author’s Original
Access Rights open access
Source Identifier
[ISSN] 1365-182X
[ISSN] 1477-2574
[DOI] 10.1016/j.hpb.2020.05.008
[DOI] https://doi.org/10.1016/j.hpb.2020.05.008