Prediction of Posthepatectomy Liver Failure Using Transient Elastography in Patients with Hepatitis B Related Hepatocellular Carcinoma

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2017 Dec 30

PMID 29284411

Citations 12

Authors

Jie-Wen Lei

Xiao-Yu Ji

Jun-Feng Hong

Wan-Bin Li

Yan Chen

Yan Pan

Jia Guo

Affiliations

Soon will be listed here.

Abstract

Background: It is essential to accurately predict Postoperative liver failure (PHLF) which is a life-threatening complication. Liver hardness measurement (LSM) is widely used in non-invasive assessment of liver fibrosis. The aims of this study were to explore the application of preoperative liver stiffness measurements (LSM) by transient elastography in predicting postoperative liver failure (PHLF) in patients with hepatitis B related hepatocellular carcinoma.

Methods: The study included 247 consecutive patients with hepatitis B related hepatocellular carcinoma who underwent hepatectomy between May 2015 and September 2015. Detailed preoperative examinations including LSM were performed before hepatectomy. The endpoint was the development of PHLF.

Results: All of the patients had chronic hepatitis B defined as the presence of hepatitis B surface antigen (HBsAg) for more than 6 months and 76 (30.8%) had cirrhosis. PHLF occurred in 37 (14.98%) patients. Preoperative LSM (odds ratio, OR, 1.21; 95% confidence interval, 95% CI: 1.13-1.29; P < 0.001) and international normalized ratio (INR) (OR, 1.07; 95% CI: 1.01-1.12; P < 0.05) were revealed to be independent risk factors for PHLF, and a new model was defined as LSM-INR index (LSM-INR index = 0.191*LSM + 6.317*INR-11.154). The optimal cutoff values of LSM and LSM-INR index for predicting PHLF were 14 kPa (AUC 0.86, 95% CI: 0.811-0.901, P < 0.001) and -1.92 (AUC 0.87, 95% CI: 0.822-0.909, P < 0.001), respectively.

Conclusions: LSM can be helpful for surgeons to make therapeutic decisions in patients with hepatitis B related hepatocellular carcinoma.

Citing Articles

Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis.

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KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease.

Kim M, Han J, An J, Kim B, Jin Y, Kim S Clin Mol Hepatol. 2024; 30(Suppl):S5-S105.

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Current status of preoperative risk assessment for posthepatectomy liver failure in patients with hepatocellular carcinoma.

Nishio T, Taura K, Koyama Y, Ishii T, Hatano E Ann Gastroenterol Surg. 2023; 7(6):871-886.

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E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy.

Primavesi F, Maglione M, Cipriani F, Denecke T, Oberkofler C, Starlinger P Br J Surg. 2023; 110(10):1331-1347.

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A Nomogram Based on Preoperative Lab Tests, BMI, ICG-R15, and EHBF for the Prediction of Post-Hepatectomy Liver Failure in Patients with Hepatocellular Carcinoma.

Zhang D, Pan Y, Yang Z, Zeng H, Wang X, Chen J J Clin Med. 2023; 12(1).

PMID: 36615125 PMC: 9821206. DOI: 10.3390/jcm12010324.

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