ArticleAnnals of surgical oncology2025
Novel Risk Score Incorporating Type-IV Collagen, Albumin, and Prothrombin Time (CAP score) to Predict 180-Day Surgery-Related Mortality After Liver Resection for Hepatocellular Carcinoma.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAccurate preoperative risk assessment is crucial for patients undergoing liver resection for hepatocellular carcinoma (HCC). The present study developed and validated a novel scoring system for predicting 180-day surgery-related mortality. PATIENTS AND
methodsThis retrospective cohort study enrolled patients who underwent liver resection for HCC between 2000 and 2024. The cohort was divided into training and validation sets on the basis of the operation dates. Multivariate analysis was performed to identify the independent predictors of 180-day surgery-related mortality. The resulting score was compared with the existing models.
resultsThree independent predictors were identified and assigned one point each: type-IV collagen ≥ 7.5 ng/mL (odds ratio [OR]: 2.92; 95% confidence interval [CI] 1.20-7.65; P = 0.017), albumin (Alb) ≤ 3.4 g/dL (OR: 3.06, 95% CI 1.23-8.39; P = 0.016), and prothrombin time-international normalized ratio (PT-INR) ≥ 1.26 (OR: 2.82; 95% CI 1.14-6.70; P = 0.026). The 180-day surgery-related mortality rates for the low- (0 point), intermediate- (1-2 points), and high-risk (3 points) groups were 0.8%, 7.6%, and 26.7%, respectively, in the training cohort, and 1.7%, 6.5%, and 20.7%, respectively, in the validation cohort. The collagen-Alb-PT-INR (CAP) score demonstrated superior predictive performance (area under the curve [AUC]: 0.728) as compared with the stratified Model for End-Stage Liver Disease score (AUC: 0.557, P < 0.001), the Child-Pugh classification (AUC: 0.637, P < 0.001), and the Alb-bilirubin grade (AUC: 0.668, P = 0.014).
conclusionsThe CAP score is a simple and effective tool for predicting 180-day surgery-related mortality post-liver resection for HCC.
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