A Novel Nomogram for Predicting Postoperative Liver Failure After Major Hepatectomy for Hepatocellular Carcinoma.
hepatocellular carcinoma
major hepatectomy
nomogram
post-hepatectomy liver failure
prediction model
Journal
Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867
Informations de publication
Date de publication:
2022
2022
Historique:
received:
18
11
2021
accepted:
14
02
2022
entrez:
1
4
2022
pubmed:
2
4
2022
medline:
2
4
2022
Statut:
epublish
Résumé
Post-hepatectomy liver failure (PHLF) is the most common cause of mortality after major hepatectomy in hepatocellular carcinoma (HCC) patients. We aim to develop a nomogram to preoperatively predict grade B/C PHLF defined by the International Study Group on Liver Surgery Grading (ISGLS) in HCC patients undergoing major hepatectomy. The consecutive HCC patients who underwent major hepatectomy at the Eastern Hepatobiliary Surgery Hospital between 2008 and 2013 served as a training cohort to develop a preoperative nomogram, and patients from 2 other hospitals comprised an external validation cohort. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied to identify preoperative predictors of grade B/C PHLF. Multivariable logistic regression was utilized to establish a nomogram model. Internal and external validations were used to verify the performance of the nomogram. The accuracy of the nomogram was also compared with the conventional scoring models, including MELD and ALBI score. A total of 880 patients who underwent major hepatectomy (668 in the training cohort and 192 in the validation cohort) were enrolled in this study. The independent risk factors of grade B/C PHLF were age, gender, prothrombin time, total bilirubin, and CSPH, which were incorporated into the nomogram. Good prediction discrimination was achieved in the training (AUROC: 0.73) and validation (AUROC: 0.72) cohorts. The calibration curve also showed good agreement in both training and validation cohorts. The nomogram has a better performance than MELD and ALBI score models. The proposed nomogram showed more accurate ability to individually predict grade B/C PHLF after major hepatectomy in HCC patients than MELD and ALBI scores.
Sections du résumé
Background
UNASSIGNED
Post-hepatectomy liver failure (PHLF) is the most common cause of mortality after major hepatectomy in hepatocellular carcinoma (HCC) patients. We aim to develop a nomogram to preoperatively predict grade B/C PHLF defined by the International Study Group on Liver Surgery Grading (ISGLS) in HCC patients undergoing major hepatectomy.
Study Design
UNASSIGNED
The consecutive HCC patients who underwent major hepatectomy at the Eastern Hepatobiliary Surgery Hospital between 2008 and 2013 served as a training cohort to develop a preoperative nomogram, and patients from 2 other hospitals comprised an external validation cohort. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied to identify preoperative predictors of grade B/C PHLF. Multivariable logistic regression was utilized to establish a nomogram model. Internal and external validations were used to verify the performance of the nomogram. The accuracy of the nomogram was also compared with the conventional scoring models, including MELD and ALBI score.
Results
UNASSIGNED
A total of 880 patients who underwent major hepatectomy (668 in the training cohort and 192 in the validation cohort) were enrolled in this study. The independent risk factors of grade B/C PHLF were age, gender, prothrombin time, total bilirubin, and CSPH, which were incorporated into the nomogram. Good prediction discrimination was achieved in the training (AUROC: 0.73) and validation (AUROC: 0.72) cohorts. The calibration curve also showed good agreement in both training and validation cohorts. The nomogram has a better performance than MELD and ALBI score models.
Conclusion
UNASSIGNED
The proposed nomogram showed more accurate ability to individually predict grade B/C PHLF after major hepatectomy in HCC patients than MELD and ALBI scores.
Identifiants
pubmed: 35359352
doi: 10.3389/fonc.2022.817895
pmc: PMC8964030
doi:
Types de publication
Journal Article
Langues
eng
Pagination
817895Informations de copyright
Copyright © 2022 Lei, Cheng, Si, Yang, Guo, Ma, Yu, Wang and Cheng.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Dig Dis. 2021;39(3):258-265
pubmed: 32846419
Hepatology. 2001 Feb;33(2):464-70
pubmed: 11172350
BMC Gastroenterol. 2021 Mar 31;21(1):142
pubmed: 33789567
J Clin Transl Hepatol. 2021 Jun 28;9(3):291-300
pubmed: 34221915
Ann Surg. 2021 Dec 1;274(6):e1209-e1217
pubmed: 32097166
Ann Transl Med. 2021 Feb;9(4):305
pubmed: 33708932
Eur J Gastroenterol Hepatol. 2015 Nov;27(11):1337-46
pubmed: 26275082
J Oncol. 2021 Apr 7;2021:6665267
pubmed: 34221013
BMJ. 2020 Oct 26;371:m3544
pubmed: 33106289
Front Oncol. 2021 Jul 02;11:667496
pubmed: 34277414
World J Surg. 2020 Dec;44(12):4197-4206
pubmed: 32860142
J Am Coll Surg. 2007 May;204(5):854-62; discussion 862-4
pubmed: 17481498
J Hepatol. 2019 Nov;71(5):920-929
pubmed: 31203152
Surg Oncol. 2019 Mar;28:78-85
pubmed: 30851917
J Surg Oncol. 2021 May;123(8):1750-1756
pubmed: 33756008
Int J Surg. 2018 Apr;52:74-81
pubmed: 29425829
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
J Cancer. 2021 Jun 26;12(17):5260-5267
pubmed: 34335942
J Clin Oncol. 2015 Feb 20;33(6):550-8
pubmed: 25512453
Clin Res Hepatol Gastroenterol. 2021 Jul;45(4):101534
pubmed: 33067168
J Hepatol. 2018 Jul;69(1):182-236
pubmed: 29628281
World J Surg. 2016 Oct;40(10):2425-40
pubmed: 27549599
HPB (Oxford). 2019 May;21(5):539-546
pubmed: 30361111
Hepatology. 2021 Aug;74(2):879-891
pubmed: 33636012
HPB (Oxford). 2019 Mar;21(3):352-360
pubmed: 30120001
Hepatology. 2018 Jan;67(1):358-380
pubmed: 28130846
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
World J Surg Oncol. 2018 Oct 16;16(1):208
pubmed: 30326907
Surgery. 2011 May;149(5):713-24
pubmed: 21236455
BMC Cancer. 2020 Oct 28;20(1):1036
pubmed: 33115425