ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
A comprehensive preoperative predictive score for post-hepatectomy liver failure after hepatocellular carcinoma resection based on patient comorbidities, tumor burden, and liver function: the CTF score.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 20 citations in OpenAlex.
- Textbook outcome after robotic liver surgery at a high-volume Scandinavian HPB center: an IWATE-based difficulty-stratified assessment of 200 cases.Surgical endoscopy · 2026Article
- Additive value of oncological resectability criteria for predicting post-hepatectomy liver failure in hepatocellular carcinoma.Updates in surgery · 2026Article
- Interpretable machine learning model predicts postoperative complications after thoracoscopic mediastinal tumor surgery: a multicenter study.BMC medical informatics and decision making · 2026Article
- Survival of patients with advanced hepatocellular carcinoma based on Gustave Roussy immune score and portal vein tumor thrombosis: a single-center, retrospective, non-randomized case-controlled study.Discover oncology · 2025Article
- The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy.Scientific reports · 2025Article
- Application of ultrasound elastography and splenic size in predicting post-hepatectomy liver failure: Unveiling new clinical perspectives.World journal of gastroenterology · 2025Article
- Development of a predictive nomogram for in-hospital death risk in multimorbid patients with hepatocellular carcinoma undergoing Palliative Locoregional Therapy.Scientific reports · 2024Article
- Risk predictors of post-hepatectomy liver failure: unraveling complexities and navigating challenges in clinical application.Hepatobiliary surgery and nutrition · 2024Article
- Impact of Surgical Margin Width on Prognosis Following Resection of Hepatocellular Carcinoma Varies on the Basis of Preoperative Alpha-Feto Protein and Tumor Burden Score.Annals of surgical oncology · 2023Article
- Survival Benefit Relative to Treatment Modalities Among Patients with Very Early Intrahepatic Cholangiocarcinoma: an Analysis of the National Cancer Database.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
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Authors and funding
19 authors at 11 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPost-hepatectomy liver failure (PHLF) is a dreaded complication following liver resection for hepatocellular carcinoma (HCC) with a high mortality rate. We sought to develop a score based on preoperative factors to predict PHLF.
methodsPatients who underwent resection for HCC between 2000 and 2020 were identified from an international multi-institutional database. Factors associated with PHLF were identified and used to develop a preoperative comorbidity-tumor burden-liver function (CTF) predictive score.
resultsAmong 1785 patients, 106 (5.9%) experienced PHLF. On multivariate analysis, several factors were associated with PHLF including high Charlson comorbidity index (CCI ≥ 5) (OR 2.80, 95%CI, 1.08-7.26), albumin-bilirubin (ALBI) (OR 1.99, 95%CI, 1.10-3.56), and tumor burden score (TBS) (OR 1.06, 95%CI, 1.02-1.11) (all p < 0.05). Using the beta-coefficients of these variables, a weighted predictive score was developed and made available online ( https://alaimolaura.shinyapps.io/PHLFriskCalculator/ ). The CTF score (c-index = 0.67) performed better than Child-Pugh score (CPS) (c-index = 0.53) or Barcelona clinic liver cancer system (BCLC) (c-index = 0.57) to predict PHLF. A high CTF score was also an independent adverse prognostic factor for survival (HR 1.61, 95%CI, 1.12-2.30) and recurrence (HR 1.36, 95%CI, 1.08-1.71) (both p = 0.01).
conclusionRoughly 1 in 20 patients experienced PHLF following resection of HCC. Patient (i.e., CCI), tumor (i.e., TBS), and liver function (i.e., ALBI) factors were associated with risk of PHLF. These preoperative factors were incorporated into a novel CTF tool that was made available online, which outperformed other previously proposed tools.
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