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. 2021 Mar;37(2):102-109.
doi: 10.1159/000510811. Epub 2020 Oct 27.

Predictors of 90-Day Mortality following Hepatic Resection for Hepatocellular Carcinoma

Geraldine Yanlei Lei  1 , Liang Shen  2 , Sameer P Junnarkar  3 , CheongWei Terence Huey  3 , JeeKeem Low  3 , Vishal G Shelat  3
Affiliations

Predictors of 90-Day Mortality following Hepatic Resection for Hepatocellular Carcinoma

Geraldine Yanlei Lei et al. Visc Med. 2021 Mar.

Abstract

Background/purpose: 90-day mortality is a key performance indicator for short-term perioperative outcome of hepatic resection (HR). Although many preoperative, intraoperative, and postoperative variables predict 90-day mortality following elective HR, only few are specific to hepatocellular carcinoma (HCC). This study aims to determine the predictors of 90-day mortality following elective HR for HCC.

Methods: We report a retrospective analysis of patients who underwent elective HR between January 1, 2007, and December 31, 2017. Health status, perioperative variables, and the presence of post-hepatectomy liver failure (PHLF) were studied. Cox's regression evaluated factors predicting 90-day mortality.

Results: Two hundred and forty-four patients diagnosed with HCC underwent HR; 102 (41.8%) underwent a major HR. The postoperative 90-day mortality rate was 5.3%. Multivariate analysis demonstrated that Child-Pugh score (p < 0.001), intraoperative blood loss (p = 0.013), the 50-50 criteria for PHLF (p < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (p = 0.007) on postoperative day 3 predict 90-day mortality.

Conclusion: In patients with HCC undergoing HR, Child-Pugh score, intraoperative blood loss, the 50-50 criteria for PHLF on postoperative day 5, and peak serum bilirubin >119 µmol/L on postoperative day 3 predict 90-day mortality following elective HR for HCC.

Keywords: Hepatic resection; Hepatocellular carcinoma.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow chart showing inclusion of study patients.
Fig. 2
Fig. 2
Survival time after hepatic resection.
See this image and copyright information in PMC

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