ArticleiLIVER2025
Development and validation of an individualized online calculator for early mortality risk after hepatectomy among patients with HCC.
Article in iLIVER, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Metabolic burden but not metabolic dysfunction-associated steatotic liver disease affects the prognosis of patients with hepatocellular carcinoma after hepatectomy: a retrospective cohort study.Journal of gastrointestinal oncology · 2026Article
- Primary Liver Cancer Trends Worldwide and in China: Analysis of GLOBOCAN 2022 Data and Disease Management Implications.Portal hypertension & cirrhosis · 2026Review
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and aims: Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally. Despite improved surgical techniques, early post-hepatectomy mortality remains a critical concern. Current staging systems and liver function classifications fail to estimate early mortality risk to guide surgical decision-making. We aimed to develop and validate an individualized online calculator to predict early post-hepatectomy mortality for HCC. Methods: Patients undergoing curative-intent hepatectomy for HCC from 2011 to 2021 at 11 Chinese centers were included. The training cohort comprised nine centers, while the external validation cohort included two centers. Multivariable logistic regression identified predictors of postoperative 90-day mortality, which were incorporated into an online calculator. Discrimination was assessed using the concordance index (C-index) and calibration by graphical plots. Results: Among 4966 patients, 90-day mortality was 4.1%. Predictors of 90-day mortality included patient performance status, prothrombin time, albumin-bilirubin (ALBI) grade, aspartate aminotransferase to platelet ratio index (APRI), tumor burden score and gross vascular invasion. The model demonstrated excellent discrimination in training and validation (C-index 0.816 and 0.801) cohorts. The proposed model outperformed staging systems (American Joint Committee on Cancer AJCC and Barcelona Clinic Liver Cancer BCLC) and liver function classifications (Child-Pugh, APRI, ALBI, and Fibrosis-4 Index FIB4) ( Conclusions: An individualized online calculator was developed and validated to predict early post-hepatectomy mortality for HCC. By identifying high-risk patients, this tool may guide surgical decision-making.
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