Observational studyMedicine2016
Risk factors for early mortality after hepatectomy for hepatocellular carcinoma.
Observational study in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Systematic review on peri-operative lactate measurements to predict outcomes in patients undergoing liver resection.Journal of hepato-biliary-pancreatic sciences · 2020Pooled it
- Hepatic clamping and postoperative hyperglycaemia: A retrospective cohort study in liver surgery.European journal of anaesthesiology and intensive care · 2026Article
- Association of perioperative bioactive adrenomedullin with early postoperative organ dysfunction after major hepatic resection: An exploratory observational study.Langenbeck's archives of surgery · 2026Observational
- Deep learning model using contrast-enhanced CT imaging features and clinical variables to predict surgical risk after hepatic resection for hepatocellular carcinoma.Frontiers in oncology · 2026Article
- Article
- Hepatic Resection as the Primary Treatment Method for Hepatocellular Carcinoma After Orthotopic Liver Transplantation.Annals of surgical oncology · 2024Article
- Surgical resection for hepatocellular carcinoma: a single-centre's one decade of experience.Annals of medicine and surgery (2012) · 2024Article
- Response to "Letter to the Editor: Does Viral Hepatitis Status Relate to Hepatocellular Carcinoma After Liver Resection?"Annals of surgical oncology · 2023Article
- Preoperative hypoalbuminaemia in liver surgery: an observational study at a university medical centre.BMJ open · 2023Observational
- Article
- High HbA1c is a risk factor for complications after hepatectomy and influences for hepatocellular carcinoma without HBV and HCV infection.Hepatobiliary surgery and nutrition · 2021Article
- Liver resection for hepatocellular carcinoma larger than 10 cm: A multi-institution long-term observational study.World journal of gastrointestinal surgery · 2021Article
- Laparoscopic Liver Resection Should Be a Standard Procedure for Hepatocellular Carcinoma with Low or Intermediate Difficulty.Journal of personalized medicine · 2021Article
- Effects of preoperative dental examination and oral hygiene instruction on surgical site infection after hepatectomy: a retrospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Combining ALT/AST Values with Surgical APGAR Score Improves Prediction of Major Complications after Hepatectomy.Journal of surgery and research · 2021Article
- Effect of delta α-fetoprotein on the detection of liver cancer recurrence.Translational cancer research · 2020Article
- Article
- Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon.BMC gastroenterology · 2018Article
- Incidence and Risk Factors for Mortality Following Bariatric Surgery: a Nationwide Registry Study.Obesity surgery · 2018Article
- RAM score is an effective predictor for early mortality and recurrence after hepatectomy for hepatocellular carcinoma.BMC cancer · 2017Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite advances in surgical technique and medical care, liver resection for hepatocellular carcinoma (HCC) remains a high-risk major operation. The present study evaluated the risk factors for early mortality after hepatectomy.We retrospectively reviewed records of patients undergoing liver resection for HCC between 1983 and 2015. A point score (Risk Assessment for early Mortality (RAM) score) for hepatectomy was developed based on multivariate analyses.Three hundred eighty-three patients (11.3%) expired within 6 months after the operation. Logistic regression analyses identified that operative duration >270 minutes and blood loss >800 cc were significant predictors of major surgical complications (P = 0.013 and 0.002, respectively). On the other hand, diabetes mellitus, albumin ≤3.5 g/dL, α-fetoprotein (AFP) >200 ng/mL, major surgical procedure, blood loss >800 cc, and major surgical complications were independent risk factors for early mortality after hepatectomy (P = 0.019, <0.001, <0.001, 0.006, 0.018, and <0.001, respectively). Risk Assessment for early Mortality score (RAM score) identified 3 subgroups of patients with distinct 6-month mortality rate, with Class III (score 10) having highest risk of early mortality.Our study demonstrated that meticulous surgical techniques to minimize blood loss and avoid prolonged operative time may help decrease the occurrence of major surgical complications. In addition to major surgical complications, diabetes mellitus, hypoalbuminemia, high AFP, massive blood loss, and major surgical procedure are also associated with early mortality after liver resection. Further study is warranted to validate the utility of RAM score as a bedside scoring system to predict postoperative outcome.
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