Value of combining albumin-bilirubin score with standardized future liver remnant in predicting post-hepatectomy liver failure of patient with hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Shuohui ¹ , YAN Jun ^1,2,4,5,6,7 , ZHANG Qiyu ^1,2,4,5,6,7 , WANG Haiping ^1,4,5,6,7 ,  LI Xun ^1,3,4,5,6,7

1. The First Clinical Medical College, Lanzhou University, Lanzhou 730000, P. R. China;
2. The Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
3. The Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
4. Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, P. R. China;
5. Gansu Province Key Laboratory of Biotherapy and Regenerative Medicine, Lanzhou 730000, P. R. China;
6. Gansu Province International Science and Technology Cooperation Base of Prevention and Control of Tumors with High Incidence and Major Chronic Diseases, Lanzhou 730000, P. R. China;
7. Gansu Province Liver Center of Integrated Traditional Chinese and West Medicine, Lanzhou 730000, P. R. China;

Corresponding author：

LI Xun, Email: lxdr21@126.com

Keywords：

hepatocellular carcinoma; albumin-bilirubin score; standardized future liver remnant; post-hepatectomy liver failure

DOI：

10.7507/1007-9424.201903012

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Objective To analyze factors affecting post-hepatectomy liver failure (PHLF) of patients with hepatocellular carcinoma (HCC) and explore value of combining albumin-bilirubin (ALBI) score with standardized future liver remnant (sFLR) in prediction of PHLF.Methods The clinical data of patients with HCC underwent curative hepatectomy in the Second and the Fifth Departments of General Surgery of the First Hospital of Lanzhou University from January 2016 to June 2018 were retrospectively reviewed. The risk factors of PHLF were identified through the logistic regression, the area under the receiver operating characteristic curve (AUC) was used to analyze the predictive value of the ALBI score, sFLR, or ALBI score×sFLR.Results A total of 72 patients with HCC were enrolled, all of them were the Child-Pugh A grade. The incidence of PHLF was 27.78% (20/72) in these 72 patients with HCC, which was 12.96% (7/54) and 72.22% (13/18) in the 54 patients with ALBI- Ⅰ grade and 18 patients with ALBI- Ⅱ grade respectively, the difference was statistically significant (P<0.001). The results of multivariable analysis of PHLF showed that the PLT (OR=0.030, P=0.018), ALBI grade (OR=11.758, P=0.020), and sFLR (OR=0.835, P=0.003) were identified as the independent predictors of PHLF. The AUC for the ALBI score×sFLR in predicting the PHLF was 0.892, it was greater than that of the ALBI score (AUC=0.799) or the sFLR (AUC=0.773).Conclusion Compared with Child-pugh grade, ALBI grade is more accurate in predicting PHLF of HCC patients, and combining ALBI score with sFLR is better than sFLR or ALBI score alone in predicting PHLF of patients with HCC.

Citation： LIU Shuohui, YAN Jun, ZHANG Qiyu, WANG Haiping, LI Xun. Value of combining albumin-bilirubin score with standardized future liver remnant in predicting post-hepatectomy liver failure of patient with hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(5): 545-550. doi: 10.7507/1007-9424.201903012 Copy

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2.	Pulitano C, Crawford M, Joseph D, et al. Preoperative assessment of post-operative liver function: the importance of residual liver volume. J Surg Oncol, 2014, 110(4): 445-450.
3.	Golse N, Bucur PO, Adam R, et al. New paradigms in post-hepatectomy liver failure. J Gastrointest Surg, 2013, 17(3): 593-605.
4.	van den Broek MA, Olde Damink SW, Dejong CH, et al. Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment. Liver Int, 2008, 28(6): 767-780.
5.	Kim HJ, Kim CY, Park EK, et al. Volumetric analysis and indocyanine green retention rate at 15 min as predictors of post-hepatectomy liver failure. HPB (Oxford), 2015, 17(2): 159-167.
6.	Guglielmi A, Ruzzenente A, Conci S, et al. How much remnant is enough in liver resection? Dig Surg, 2012, 29(1): 6-17.
7.	Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg, 2009, 250(4): 540-548.
8.	周雨, 简志祥. 术前肝储备功能评估与手术决策. 中华肝脏外科手术学电子杂志, 2018, 7(5): 364-370.
9.	Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. J Clin Oncol, 2015, 33(6): 550-558.
10.	Ochiai T, Ikoma H, Yamamoto Y, et al. Anatomical hepatectomy for hepatocellular carcinoma in patients with preserved liver function. Anticancer Res, 2013, 33(4): 1689-1695.
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13.	倪俊声, 周伟平. 肝脏切除术后并发症及肝功能衰竭评价标准. 中华普通外科杂志, 2014, 29(7): 566-568.
14.	Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg, 1973, 60(8): 646-649.
15.	Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology, 2001, 33(2): 464-470.
16.	Zou H, Wen Y, Yuan K, et al. Combining albumin-bilirubin score with future liver remnant predicts post-hepatectomy liver failure in HBV-associated HCC patients. Liver Int, 2018, 38(3): 494-502.
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20.	Narita M, Oussoultzoglou E, Fuchshuber P, et al. What is a safe future liver remnant size in patients undergoing major hepatectomy for colorectal liver metastases and treated by intensive preoperative chemotherapy? Ann Surg Oncol, 2012, 19(8): 2526-2538.
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24.	侯建存, 张雅敏, 王连江, 等. 肝脏影像解读分析系统在精准肝切除手术规划中的应用. 中国普外基础与临床杂志, 2014, 21(2): 142-145.
25.	董家鸿, 郑树森, 陈孝平, 等. 肝切除术前肝脏储备功能评估的专家共识(2011版). 中华消化外科杂志, 2011, 10(1): 20-25.

1. 郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
2. Pulitano C, Crawford M, Joseph D, et al. Preoperative assessment of post-operative liver function: the importance of residual liver volume. J Surg Oncol, 2014, 110(4): 445-450.
3. Golse N, Bucur PO, Adam R, et al. New paradigms in post-hepatectomy liver failure. J Gastrointest Surg, 2013, 17(3): 593-605.
4. van den Broek MA, Olde Damink SW, Dejong CH, et al. Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment. Liver Int, 2008, 28(6): 767-780.
5. Kim HJ, Kim CY, Park EK, et al. Volumetric analysis and indocyanine green retention rate at 15 min as predictors of post-hepatectomy liver failure. HPB (Oxford), 2015, 17(2): 159-167.
6. Guglielmi A, Ruzzenente A, Conci S, et al. How much remnant is enough in liver resection? Dig Surg, 2012, 29(1): 6-17.
7. Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg, 2009, 250(4): 540-548.
8. 周雨, 简志祥. 术前肝储备功能评估与手术决策. 中华肝脏外科手术学电子杂志, 2018, 7(5): 364-370.
9. Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. J Clin Oncol, 2015, 33(6): 550-558.
10. Ochiai T, Ikoma H, Yamamoto Y, et al. Anatomical hepatectomy for hepatocellular carcinoma in patients with preserved liver function. Anticancer Res, 2013, 33(4): 1689-1695.
11. Pang YY. The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000; 2:333-39. HPB (Oxford), 2002, 4(2): 99-99.
12. Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery, 2011, 149(5): 713-724.
13. 倪俊声, 周伟平. 肝脏切除术后并发症及肝功能衰竭评价标准. 中华普通外科杂志, 2014, 29(7): 566-568.
14. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg, 1973, 60(8): 646-649.
15. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology, 2001, 33(2): 464-470.
16. Zou H, Wen Y, Yuan K, et al. Combining albumin-bilirubin score with future liver remnant predicts post-hepatectomy liver failure in HBV-associated HCC patients. Liver Int, 2018, 38(3): 494-502.
17. 中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017年版). 传染病信息, 2017, 30(3): 111-127.
18. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet, 2012, 379(9822): 1245-1255.
19. Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
20. Narita M, Oussoultzoglou E, Fuchshuber P, et al. What is a safe future liver remnant size in patients undergoing major hepatectomy for colorectal liver metastases and treated by intensive preoperative chemotherapy? Ann Surg Oncol, 2012, 19(8): 2526-2538.
21. Schindl MJ, Redhead DN, Fearon KC, et al. The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut, 2005, 54(2): 289-296.
22. Bruix J, Sherman M, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
23. Simpson AL, Geller DA, Hemming AW, et al. Liver planning software accurately predicts postoperative liver volume and measures early regeneration. J Am Coll Surg, 2014, 219(2): 199-207.
24. 侯建存, 张雅敏, 王连江, 等. 肝脏影像解读分析系统在精准肝切除手术规划中的应用. 中国普外基础与临床杂志, 2014, 21(2): 142-145.
25. 董家鸿, 郑树森, 陈孝平, 等. 肝切除术前肝脏储备功能评估的专家共识(2011版). 中华消化外科杂志, 2011, 10(1): 20-25.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of combining albumin-bilirubin score with standardized future liver remnant in predicting post-hepatectomy liver failure of patient with hepatocellular carcinoma

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