ArticleEuropean radiology2023
Predicting symptomatic post-hepatectomy liver failure in patients with hepatocellular carcinoma: development and validation of a preoperative nomogram.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Specific Items of Enhanced Recovery After Surgery for Liver Surgery in Cirrhotic Patients: A Systematic Review.World journal of surgery · 2025Pooled it
- 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
- Mapping the knowledge domains of literature on hepatocellular carcinoma and liver failure: a bibliometric approach.Frontiers in oncology · 2025Pooled it
- KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease.Clinical and molecular hepatology · 2024Guideline
- Deep learning-based volumetry of the future liver remnants and prediction of candidates for major hepatectomy.BMC medical imaging · 2025Article
- Role of two-dimensional shear wave elastography in predicting post-hepatectomy liver failure: A step forwards in hepatic surgery.World journal of gastrointestinal surgery · 2025Article
- Liver stiffness in hepatocellular carcinoma and chronic hepatitis patients: Hepatitis B virus infection and transaminases should be considered.World journal of hepatology · 2024Article
- Ultrasound Shear Wave Elastography Evaluation of the Liver and Implications for Perioperative Medicine.Journal of clinical medicine · 2024Review
- Risk predictors of post-hepatectomy liver failure: unraveling complexities and navigating challenges in clinical application.Hepatobiliary surgery and nutrition · 2024Article
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13 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo develop and validate a nomogram based on liver stiffness (LS) for predicting symptomatic post-hepatectomy (PHLF) in patients with hepatocellular carcinoma (HCC).
methodsA total of 266 patients with HCC were enrolled prospectively from three tertiary referral hospitals from August 2018 to April 2021. All patients underwent preoperative laboratory examination to obtain parameters of liver function. Two-dimensional shear wave elastography (2D-SWE) was performed to measure LS. Three-dimensional virtual resection obtained the different volumes including future liver remnant (FLR). A nomogram was developed by using logistic regression and determined by receiver operating characteristic (ROC) curve analysis and calibration curve analysis, which was validated internally and externally.
resultsA nomogram was constructed with the following variables: FLR ratio (FLR of total liver volume), LS greater than 9.5 kPa, Child-Pugh grade, and the presence of clinically significant portal hypertension (CSPH). This nomogram enabled differentiation of symptomatic PHLF in the derivation cohort (area under curve [AUC], 0.915), internal fivefold cross-validation (mean AUC, 0.918), internal validation cohort (AUC, 0.876) and external validation cohort (AUC, 0.845). The nomogram also showed good calibration in the derivation, internal validation, and external validation cohorts (Hosmer-Lemeshow goodness-of-fit test, p = 0.641, p = 0.06, and p = 0.127, respectively). Accordingly, the safe limit of the FLR ratio was stratified using the nomogram.
conclusionAn elevated level of LS was associated with the occurrence of symptomatic PHLF in HCC. A preoperative nomogram integrating LS, clinical and volumetric features was useful in predicting postoperative outcomes in patients with HCC, which might help surgeons in the management of HCC resection. CLINICAL RELEVANCE STATEMENT: A serial of the safe limit of the future liver remnant was proposed by a preoperative nomogram for hepatocellular carcinoma, which might help surgeons in 'how much remnant is enough in liver resection'. KEY POINTS: • An elevated liver stiffness with the best cutoff value of 9.5 kPa was associated with the occurrence of symptomatic post-hepatectomy liver failure in hepatocellular carcinoma. • A nomogram based on both quality (Child-Pugh grade, liver stiffness, and portal hypertension) and quantity of future liver remnant was developed to predict symptomatic post-hepatectomy liver failure for HCC, which enabled good discrimination and calibration in both derivation and validation cohorts. • The safe limit of future liver remnant volume was stratified using the proposed nomogram, which might help surgeons in the management of HCC resection.
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