ArticleCancers2020
Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma.
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Article in Cancers, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Diagnostic Performance of SWE and Predictive Models Based on SWE for Post- Hepatectomy Liver Failure: A Systematic Review and Meta-analysis.Current medical imaging · 2025Pooled it
- Lenvatinib plus anti-PD-1 antibodies as conversion therapy for patients with unresectable intermediate-advanced hepatocellular carcinoma: a single-arm, phase II trial.Journal for immunotherapy of cancer · 2023Trial
- CTC cluster in breast cancer: synergetic metastasis promotion mechanism and transformation path from platelet cloaking to leukocyte escort.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Comparisons of clinical patterns, short- and long-term prognostic outcomes in patients stratified by the severity of microvascular invasion after curative resection for hepatocellular carcinoma.World journal of surgical oncology · 2026Article
- Assessing complications following pancreatoduodenectomy: the Comprehensive Complication Index versus the Clavien-Dindo classification.BJS open · 2025Article
- The role of the comprehensive complication index in the prediction of tumor-related death in transplanted patients with hepatocellular carcinoma.Updates in surgery · 2025Article
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- Realizing Textbook Outcomes Following Liver Resection for Hepatic Neoplasms with Development and Validation of a Predictive Nomogram.Annals of surgical oncology · 2024Article
- Laparoscopic versus open hepatic resection in patients ≥75 years old: A NSQIP analysis evaluating 2674 patients.Journal of surgical oncology · 2024Article
- Prediction of postoperative complications after hepatectomy with dynamic monitoring of central venous oxygen saturation.BMC surgery · 2023Article
- Accumulation of Postoperative Unexpected Events Assessed by the Comprehensive Complication IndexChildren (Basel, Switzerland) · 2022Article
- The role of EphA7 in different tumors.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2022Review
- Imaging Features of Post Main Hepatectomy Complications: The Radiologist Challenging.Diagnostics (Basel, Switzerland) · 2022Review
- Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center.BMC gastroenterology · 2022Article
- [Research Updates: Standardized Reporting and Evaluation Instruments for Postoperative Complications].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022Review
- Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?World journal of gastroenterology · 2021Review
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Authors and funding
74 authors at 20 institutions in 1 country.
Alessandro GianiSchool of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.ORCID 0000-0003-0718-2321
Federica CiprianiHepatobiliary Surgery Division, Ospedale San Raffaele, 20132 Milan, Italy.
Simone FamularoSchool of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.ORCID 0000-0002-9721-6304
Matteo DonadonDepartment of Hepatobiliary and General Surgery, Humanitas University, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy.ORCID 0000-0003-0296-7648
Davide P BernasconiBicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
Francesco ArditoHepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, 00118 Rome, Italy.ORCID 0000-0003-1596-2862
Federico FazioDepartment of General and Oncological Surgery, Mauriziano Hospital "Umberto I", 10112 Turin, Italy.ORCID 0000-0002-9112-9365
Daniele NicoliniHepatopancreatobiliary and Transplant Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy.ORCID 0000-0002-5477-3346
Pasquale PerriDivision of Hepatobiliarypancreatic surgery, IRCCS-Regina Elena National Cancer Institute, 00119 Rome, Italy.
Mario GiuffridaDepartment of Medicine and Surgery, University of Parma, 43126 Parma, Italy.ORCID 0000-0001-8335-3941
Nicholas PontaroloUnit of General Surgery 1, University of Pavia and Foundation IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Matteo ZanelloDepartment of Surgery, AOU Sant'Orsola Malpighi, IRCCS Azienda Ospedaliera Universitaria, 40141 Bologna, Italy.
Quirino LaiHepatobiliary and Organ Transplantation Unit, Sapienza University of Rome, Umberto I Polyclinic of Rome, 00118 Rome, Italy.ORCID 0000-0003-1487-3235
Simone ConciDivision of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37121 Verona, Italy.
Sarah MolfinoDepartment of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy.ORCID 0000-0003-3510-9041
Paola GermaniDepartment of General Surgery, ASUGI, University Hospital of Trieste, 34121 Trieste, Italy.ORCID 0000-0002-0565-0489
Enrico PinottiDepartment of Surgery, Ponte San Pietro Hospital, 24129 Bergamo, Italy.
Maurizio RomanoDepartment of Surgical, Oncological and Gastroenterological Science (DISCOG), University of Padua; Hepatobiliary and Pancreatic Surgery Unit-Treviso Hospital, 31102 Treviso, Italy.
Giuliano La BarbaGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, 47122 Forlì, Italy.ORCID 0000-0002-9663-8580
Cecilia FerrariHPB Surgical Unit, San Paolo Hospital, 17100 Savona, Italy.ORCID 0000-0002-0385-5851
Stefan PataunerDepartment of Surgery, Bolzano Central Hospital, 39100 Bolzano, Italy.
Alberto ManzoniDepartment of General Surgery, Poliambulanza Foundation Hospital, 25136 Brescia, Italy.
Ivano SciannameaDepartment of Surgery, Monza Polyclinic, 20900 Monza, Italy.
Luca FumagalliDepartment of Emergency and Robotic Surgery, ASST Lecco, 23900 Lecco, Italy.
Albert TrociDepartment of Surgery, L. Sacco Hospital, 20143 Milan, Italy.ORCID 0000-0002-0832-2966
Valentina FerraroDepartment of Hepato-Pancreatic-Biliary Surgery, Miulli Hospital, 70132 Bari, Italy.
Antonio FloridiDepartment of General Surgery, ASST Crema, 26013 Crema, Italy.
Riccardo MemeoDepartment of Hepato-Pancreatic-Biliary Surgery, Miulli Hospital, 70132 Bari, Italy.
Michele CrespiDepartment of Surgery, L. Sacco Hospital, 20143 Milan, Italy.
Marco ChiarelliDepartment of Emergency and Robotic Surgery, ASST Lecco, 23900 Lecco, Italy.
Adelmo AntonucciDepartment of Surgery, Monza Polyclinic, 20900 Monza, Italy.
Giuseppe ZimmittiDepartment of General Surgery, Poliambulanza Foundation Hospital, 25136 Brescia, Italy.
Antonio FrenaDepartment of Surgery, Bolzano Central Hospital, 39100 Bolzano, Italy.ORCID 0000-0001-9461-5345
Andrea PercivaleHPB Surgical Unit, San Paolo Hospital, 17100 Savona, Italy.
Giorgio ErcolaniGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, 47122 Forlì, Italy.
Giacomo ZanusDepartment of Surgical, Oncological and Gastroenterological Science (DISCOG), University of Padua; Hepatobiliary and Pancreatic Surgery Unit-Treviso Hospital, 31102 Treviso, Italy.
Mauro ZagoDepartment of Surgery, Ponte San Pietro Hospital, 24129 Bergamo, Italy.ORCID 0000-0001-9322-0798
Paola TarchiDepartment of General Surgery, ASUGI, University Hospital of Trieste, 34121 Trieste, Italy.ORCID 0000-0002-7139-3951
Gian Luca BaiocchiDepartment of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy.
Andrea RuzzenenteDivision of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37121 Verona, Italy.
Massimo RossiHepatobiliary and Organ Transplantation Unit, Sapienza University of Rome, Umberto I Polyclinic of Rome, 00118 Rome, Italy.
Elio JovineDepartment of Surgery, AOU Sant'Orsola Malpighi, IRCCS Azienda Ospedaliera Universitaria, 40141 Bologna, Italy.
Marcello MaestriUnit of General Surgery 1, University of Pavia and Foundation IRCCS Policlinico San Matteo, 27100 Pavia, Italy.ORCID 0000-0002-5693-9151
Raffaele Dalla ValleDepartment of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
GianLuca GraziDivision of Hepatobiliarypancreatic surgery, IRCCS-Regina Elena National Cancer Institute, 00119 Rome, Italy.ORCID 0000-0002-3279-0313
Marco VivarelliHepatopancreatobiliary and Transplant Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy.
Alessandro FerreroDepartment of General and Oncological Surgery, Mauriziano Hospital "Umberto I", 10112 Turin, Italy.
Felice GiulianteHepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, 00118 Rome, Italy.
Guido TorzilliDepartment of Hepatobiliary and General Surgery, Humanitas University, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy.
Luca AldrighettiHepatobiliary Surgery Division, Ospedale San Raffaele, 20132 Milan, Italy.
Luca GianottiSchool of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.ORCID 0000-0001-7335-8394
Fabrizio RomanoSchool of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
Cristina CiulliSchool of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
Marco BragaSchool of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
Francesca RattiHepatobiliary Surgery Division, Ospedale San Raffaele, 20132 Milan, Italy.
Guido CostaDepartment of Hepatobiliary and General Surgery, Humanitas University, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy.
Francesco RazionaleHepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, 00118 Rome, Italy.
Nadia RussolilloDepartment of General and Oncological Surgery, Mauriziano Hospital "Umberto I", 10112 Turin, Italy.
Laura MarinelliHepatopancreatobiliary and Transplant Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy.ORCID 0000-0003-4022-495X
Valerio De PeppoDivision of Hepatobiliarypancreatic surgery, IRCCS-Regina Elena National Cancer Institute, 00119 Rome, Italy.ORCID 0000-0002-1603-0787
Elena CremaschiDepartment of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Francesco CalabreseUnit of General Surgery 1, University of Pavia and Foundation IRCCS Policlinico San Matteo, 27100 Pavia, Italy.ORCID 0000-0002-9580-9464
Zoe Larghi LaureiroHepatobiliary and Organ Transplantation Unit, Sapienza University of Rome, Umberto I Polyclinic of Rome, 00118 Rome, Italy.
Giovanni LazzariDivision of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37121 Verona, Italy.
Davide CosolaDepartment of General Surgery, ASUGI, University Hospital of Trieste, 34121 Trieste, Italy.
Mauro MontuoriDepartment of Surgery, Ponte San Pietro Hospital, 24129 Bergamo, Italy.ORCID 0000-0002-7968-2109
Luca SalvadorDepartment of Surgical, Oncological and Gastroenterological Science (DISCOG), University of Padua; Hepatobiliary and Pancreatic Surgery Unit-Treviso Hospital, 31102 Treviso, Italy.
Alessandro CucchettiGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, 47122 Forlì, Italy.
Angelo FranceschiHPB Surgical Unit, San Paolo Hospital, 17100 Savona, Italy.
Michele CiolaDepartment of Surgery, Bolzano Central Hospital, 39100 Bolzano, Italy.
Valentina SegaDepartment of General Surgery, Poliambulanza Foundation Hospital, 25136 Brescia, Italy.
Pietro CalcagnoDepartment of Emergency and Robotic Surgery, ASST Lecco, 23900 Lecco, Italy.
Luca PennacchiDepartment of Surgery, L. Sacco Hospital, 20143 Milan, Italy.ORCID 0000-0002-0449-4496
Michele TedeschiDepartment of Hepato-Pancreatic-Biliary Surgery, Miulli Hospital, 70132 Bari, Italy.
Aziende Socio Sanitarie Territoriali di LeccoHumanitas University · ITAzienda Ospedaliera San Gerardo · ITFondazione Poliambulanza Istituto Ospedaliero · ITIRCCS Ospedale San Raffaele · ITIstituti di Ricovero e Cura a Carattere Scientifico · ITLuigi Sacco Hospital · ITOspedale di Bolzano · ITOspedale G.B. Morgagni - L.Pierantoni · ITOspedale San Paolo · ITPoliclinico Umberto I · ITUniversità Cattolica del Sacro Cuore · ITUniversity of Milano-Bicocca · ITUniversity of Padua · ITUniversity of Parma · ITUniversity of Pavia · ITUniversity of Trieste · ITUniversity of Verona · ITIRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola · ITUniversity of Brescia · IT
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed to assess the ability of comprehensive complication index (CCI) and Clavien-Dindo complication (CDC) scale to predict excessive length of hospital stay (e-LOS) in patients undergoing liver resection for hepatocellular carcinoma.
methodsPatients were identified from an Italian multi-institutional database and randomly selected to be included in either a derivation or validation set. Multivariate logistic regression models and ROC curve analysis including either CCI or CDC as predictors of e-LOS were fitted to compare predictive performance. E-LOS was defined as a LOS longer than the 75th percentile among patients with at least one complication.
resultsA total of 2669 patients were analyzed (1345 for derivation and 1324 for validation). The odds ratio (OR) was 5.590 (95%CI 4.201; 7.438) for CCI and 5.507 (4.152; 7.304) for CDC. The AUC was 0.964 for CCI and 0.893 for CDC in the derivation set and 0.962 vs. 0.890 in the validation set, respectively. In patients with at least two complications, the OR was 2.793 (1.896; 4.115) for CCI and 2.439 (1.666; 3.570) for CDC with an AUC of 0.850 and 0.673, respectively in the derivation cohort. The AUC was 0.806 for CCI and 0.658 for CDC in the validation set.
conclusionsWhen reporting postoperative morbidity in liver surgery, CCI is a preferable scale.
Indexed as
Clavien-Dindo classificationcomprehensive complication indexhepatocellular carcinomalength of stayliver surgerymorbidityperformance
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