Haiqing Wang1, Lei Li2, Wentao Bo1, Aixiang Liu1, Xielin Feng1, Yong Hu1, Lang Tian1, Hui Zhang1, Xiaoli Tang3, Lixia Zhang1, Mingyi Zhang1. 1. Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China. 2. Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China. 3. Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China. Electronic address: tangxiaoliszlyy@163.com.
Abstract
BACKGROUND: Postoperative liver failure remains the main complication and predominant cause of hepatectomy-related mortality for patients undergoing liver resection. AIM: Our aim is to investigate whether immediate postoperative Fibrosis-4 could predict postoperative liver failure. METHODS: We retrospectively enrolled 1353 consecutive hepatocellular carcinoma patients undergoing radical resection. The characteristics and clinical outcomes were compared between patients with high and low immediate postoperative Fibrosis-4. Risk factors for hepatic failure were evaluated by univariate and multivariate analysis. RESULTS: Using a receiver operating characteristic curve, immediate postoperative Fibrosis-4 showed good prediction ability for postoperative liver failure (AUROC=0.647, P<0.001). With the optimal cut-off value of 5.9, the high postoperative Fibrosis-4 group (Fibrosis-4<5.9) had higher postoperative complication (39.1% vs 28.6%, P<0.001), mortality (2.8% vs 0.6%, P<0.001) and liver failure (13.9% vs 6.2%, P<0.001). In addition, patients with high Fibrosis-4 had worse and delayed recovery of liver function. By univariate and multivariate analysis, Fibrosis-4, as well as liver removed volume, total bilirubin and albumin was identified as independent risk factor for postoperative liver failure. CONCLUSIONS: Immediate postoperative Fibrosis-4 showed good prediction ability for postoperative liver failure, and required measure should be taken to prevent liver failure when high postoperative Fibrosis-4 appeared.
BACKGROUND:Postoperative liver failure remains the main complication and predominant cause of hepatectomy-related mortality for patients undergoing liver resection. AIM: Our aim is to investigate whether immediate postoperative Fibrosis-4 could predict postoperative liver failure. METHODS: We retrospectively enrolled 1353 consecutive hepatocellular carcinomapatients undergoing radical resection. The characteristics and clinical outcomes were compared between patients with high and low immediate postoperative Fibrosis-4. Risk factors for hepatic failure were evaluated by univariate and multivariate analysis. RESULTS: Using a receiver operating characteristic curve, immediate postoperative Fibrosis-4 showed good prediction ability for postoperative liver failure (AUROC=0.647, P<0.001). With the optimal cut-off value of 5.9, the high postoperative Fibrosis-4 group (Fibrosis-4<5.9) had higher postoperative complication (39.1% vs 28.6%, P<0.001), mortality (2.8% vs 0.6%, P<0.001) and liver failure (13.9% vs 6.2%, P<0.001). In addition, patients with high Fibrosis-4 had worse and delayed recovery of liver function. By univariate and multivariate analysis, Fibrosis-4, as well as liver removed volume, total bilirubin and albumin was identified as independent risk factor for postoperative liver failure. CONCLUSIONS: Immediate postoperative Fibrosis-4 showed good prediction ability for postoperative liver failure, and required measure should be taken to prevent liver failure when high postoperative Fibrosis-4 appeared.