Preoperative aspartate aminotransferase-to-platelet-ratio index as a predictor of posthepatectomy liver failure for resectable hepatocellular carcinoma

Autor: Rongyun Mai, Guo-bin Wu, Jie Chen, Xianmao Shi, Tao Bai, Fei-Xiang Wu, Jiazhou Ye, Le-Qun Li, Zhongrong Long
Rok vydání: 2019
Předmět:
Zdroj: Cancer Management and Research
ISSN: 1179-1322
DOI: 10.2147/cmar.s186114
Popis: Rong-Yun Mai, Jia-Zhou Ye, Zhong-Rong Long, Xian-Mao Shi, Tao Bai, Jie Chen, Le-Qun Li, Guo-Bin Wu, Fei-Xiang Wu Department of Hepatobiliary and Pancreatic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuangzu 530021, China Purpose: This study aimed to investigate the efficacy of preoperative aspartate aminotransferase-to-platelet-ratio index (APRI) score to predict the risk of posthepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC) after liver resection, and to compare the discriminatory performance of the APRI with the Child–Pugh score, model for end-stage liver disease (MELD) score, and albumin–bilirubin (ALBI) score. Patients and methods: A total of 1,044 consecutive patients with HCC who underwent liver resection were enrolled and studied. Univariate and multivariate analyses were performed to investigate risk factors associated with PHLF. Predictive discrimination of Child–Pugh, MELD, ALBI, and APRI scores for predicting PHLF were assessed according to area under the ROC curve. The cutoff value of the APRI score for predicting PHLF was determined by ROC analysis. APRI scores were stratified by dichotomy to analyze correlations with incidence and grade of PHLF. Results: PHLF occurred in 213 (20.4%) patients. Univariate and multivariate analyses revealed that Child–Pugh, MELD, ALBI, and APRI scores were significantly associated with PHLF. Area under the ROC analysis revealed that the APRI score for predicting PHLF was significantly more accurate than Child–Pugh, MELD, or ALBI scores. With an optimal cutoff value of 0.55, the sensitivity and specificity of the APRI score for predicting PHLF were 72.2% and 68.0%, respectively, and the incidence and grade of PHLF in patients with high risk (APRI score >0.55) was significantly higher than in the low-risk cohort (APRI score
Databáze: OpenAIRE