End-stage liver disease score and future liver remnant volume predict post-hepatectomy liver failure in hepatocellular carcinoma

作     者：Fan-Hua Kong Xiong-Ying Miao Heng Zou Li Xiong Yu Wen Bo Chen Xi Liu Jiang-Jiao Zhou 

作者机构：Department of General Surgery The Second Xiangya Hospital Central South University 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第22期

页      面：3734-3741页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by the National Natural Science Foundation of China,No.81970569,No.81773293,and No.31660266 Natural Science Foundation of Hunan Province,No.2015JJ4083,No.2019JJ50874,and No.2018JJ3758 

主　　题：Post-hepatectomy liver failure Hepatocellular carcinoma Hepatectomy Model for end-stage liver disease Standardized future liver remnant Hepatitis B virus 

摘      要：BACKGROUND Hepatocellular carcinoma(HCC)is the world’s sixth most common malignant tumor and the third cause of cancer *** great progress has been made in hepatectomy,it is still associated with a certain degree of risk of posthepatectomy liver failure(PHLF),which extends the length of hospital stay and remains the leading cause of postoperative *** have shown that assessment of hepatic functional reserve before hepatectomy is beneficial for reducing the incidence of *** To assess the value of model for end-stage liver disease(MELD)score combined with standardized future liver remnant(sFLR)volume in predicting PHLF in patients undergoing hepatectomy for *** This study was attended by 238 patients with HCC who underwent hepatectomy between January 2015 and January *** of sFLR volume,MELD score,and sFLR/MELD ratio to predict PHLF was evaluated according to the area under the receiver operating characteristic *** The patients were divided into two groups according to whether PHLF occurred after *** incidence of PHLF was 8.4%in our *** incidence of PHLF increased with the decrease in sFLR volume and the increase in MELD *** sFLR volume and MELD score were considered independent predictive factors for ***,the cut-off value of the sFLR/MELD score to predict PHLF was 0.078(P0.001).This suggests that an sFLR/MELD≥0.078 indicates a higher incidence of PHLF than an sFLR/MELD*** MELD combined with sFLR is a reliable and effective PHLF predictor,which is superior to MELD score or sFLR volume alone.