Evidence map›Paper›PMID 41882262›Full record

ArticleAnnals of surgical oncology2026

Noninvasive Tests for Liver Fibrosis Predict Postoperative Complications After Resection of Colorectal Liver Metastases.

Christopher Tuffs, Oliver Marg, Daniar Amin, Tamal Sarkar, Christopher Schramm, Alen Kosovic, Jonathan M Harnoss, Christoph Kahlert, Mohammed Al-Saeedi, Martin Reichert and 4 more

Abstract read
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Christopher TuffsJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Oliver MargJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Daniar AminJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Tamal SarkarJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Christopher SchrammJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Alen KosovicJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Jonathan M HarnossJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Christoph KahlertDepartment of General, Visceral, and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Mohammed Al-SaeediDepartment of General, Visceral, and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Martin ReichertJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Andreas HeckerJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Elke RoebJustus-Liebig-University of Giessen, University Hospital Giessen, Department of Gastroenterology, Giessen, Germany.
Martin SchneiderJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany.
Moritz J StrowitzkiJustus-Liebig-University Giessen, University Hospital Giessen, Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen, Germany. Moritz.Strowitzki@chiru.med.uni-giessen.de.

Funding

Bundesministerium für Bildung und Forschung 031L0084Deutsche Forschungsgemeinschaft #532010140Deutsche Forschungsgemeinschaft SCHN 947/4-2Deutsche Forschungsgemeinschaft STR 1570/2-1Deutsche Krebshilfe #70114848Von-Behring-Röntgen-Stiftung #72-0043
6 · The paper itself

Abstract

backgroundColorectal liver metastases (CRLM) occur in up to 50% of patients who suffer from colorectal cancer. While liver resection of CRLM remains the only curative treatment option, postoperative complications are common and mitigate the beneficial effects of CRLM resection on quality of life and survival in these patients. Liver fibrosis is a known risk factor for surgical morbidity and mortality after liver surgery. However, preoperative detection of liver fibrosis remains challenging. Noninvasive tests facilitate the diagnosis of liver fibrosis without the need for liver biopsies and histological grading. We thus analyzed the significance of noninvasive tests for liver fibrosis, including FIB-4 index and SAFE score, to predict adverse short-term outcome after CRLM resection.

methodsA retrospective analysis of 107 patients who underwent surgery for CRLM at the Department for General, Visceral, Thoracic, and Transplantation Surgery of the University Hospital Giessen was performed to assess the correlation between suggested liver fibrosis as defined by noninvasive tests and short-term outcome.

resultsA high FIB-4 index or SAFE score, predictive of liver fibrosis, was associated with increased incidence and severity of postoperative complications. These results were validated and confirmed in an external, independent patient cohort of 277 patients who underwent liver resection owing to CRLM at the Department for General, Visceral, and Transplantation Surgery of the University Hospital Heidelberg.

conclusionOur findings provide a rationale for preoperative assessment of the FIB-4 index and SAFE score, as indicators of liver fibrosis, to identify CRLM patients at higher risk for postoperative complications.

Indexed as

Colorectal NeoplasmsHepatectomyLiver CirrhosisLiver NeoplasmsPostoperative ComplicationsAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateColorectal liver metastasesLiver fibrosisLiver resectionNon-invasive testsPostoperative complications

Identifiers

PMID41882262
PMCPMC13242414

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.