Model to predict major complications following liver resection for HCC in patients with metabolic syndrome
| Autor: | Giammauro Berardi, Francesca Ratti, Carlo Sposito, Martina Nebbia, Daniel M. D’Souza, Franco Pascual, Epameinondas Dogeas, Samer Tohme, Francesco E. D’Amico, Remo Alessandris, Ilaria Simonelli, Celeste Del Basso, Nadia Russolillo, Amika Moro, Guido Fiorentini, Matteo Serenari, Fernando Rotellar, Giuseppe Zimmitti, Simone Famularo, Tommy Ivanics, Daniel Hoffman, Edwin Onkendi, Yasmin Essaji, Santiago Lopez Ben, Celia Caula, Gianluca Rompianesi, Asmita Chopra, Mohammed Abu Hilal, Guido Torzilli, Gonzalo Sapisochin, Carlos Corvera, Adnan Alseidi, Scott Helton, Roberto I. Troisi, Kerri Simo, Claudius Conrad, Matteo Cescon, Sean Cleary, Choon H.D. Kwon, Alessandro Ferrero, Giuseppe M. Ettorre, Umberto Cillo, David Geller, Daniel Cherqui, Pablo E. Serrano, Cristina Ferrone, Vincenzo Mazzaferro, Luca Aldrighetti, T. Peter Kingham |
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| Přispěvatelé: | Berardi, Giammauro, Ratti, Francesca, Sposito, Carlo, Nebbia, Martina, D'Souza, Daniel M, Pascual, Franco, Dogeas, Epameinonda, Tohme, Samer, D'Amico, Francesco E, Alessandris, Remo, Simonelli, Ilaria, Del Basso, Celeste, Russolillo, Nadia, Moro, Amika, Fiorentini, Guido, Serenari, Matteo, Rotellar, Fernando, Zimmitti, Giuseppe, Famularo, Simone, Ivanics, Tommy, Hoffman, Daniel, Onkendi, Edwin, Essaji, Yasmin, Lopez Ben, Santiago, Caula, Celia, Rompianesi, Gianluca, Chopra, Asmita, Abu Hilal, Mohammed, Torzilli, Guido, Sapisochin, Gonzalo, Corvera, Carlo, Alseidi, Adnan, Helton, Scott, Troisi, Roberto I, Simo, Kerri, Conrad, Claudiu, Cescon, Matteo, Cleary, Sean, Kwon, Choon H D, Ferrero, Alessandro, Ettorre, Giuseppe M, Cillo, Umberto, Geller, David, Cherqui, Daniel, Serrano, Pablo E, Ferrone, Cristina, Mazzaferro, Vincenzo, Aldrighetti, Luca, Kingham, T Peter |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Popis: | Background: Metabolic syndrome (MS) is rapidly growing as risk factor for HCC. Liver resection for HCC in patients with MS is associated with increased postoperative risks. There are no data on factors associated with postoperative complications. Aims: The aim was to identify risk factors and develop and validate a model for postoperative major morbidity after liver resection for HCC in patients with MS, using a large multicentric Western cohort. Materials and methods: The univariable logistic regression analysis was applied to select predictive factors for 90 days major morbidity. The model was built on the multivariable regression and presented as a nomogram. Performance was evaluated by internal validation through the bootstrap method. The predictive discrimination was assessed through the concordance index. Results: A total of 1087 patients were gathered from 24 centers between 2001 and 2021. Four hundred and eighty-four patients (45.2%) were obese. Most liver resections were performed using an open approach (59.1%), and 743 (68.3%) underwent minor hepatectomies. Three hundred and seventy-six patients (34.6%) developed postoperative complications, with 13.8% major morbidity and 2.9% mortality rates. Seven hundred and thirteen patients had complete data and were included in the prediction model. The model identified obesity, diabetes, ischemic heart disease, portal hypertension, open approach, major hepatectomy, and changes in the nontumoral parenchyma as risk factors for major morbidity. The model demonstrated an AUC of 72.8% (95% CI: 67.2%-78.2%) (https://childb.shinyapps.io/NomogramMajorMorbidity90days/). Conclusions: Patients undergoing liver resection for HCC and MS are at high risk of postoperative major complications and death. Careful patient selection, considering baseline characteristics, liver function, and type of surgery, is key to achieving optimal outcomes. |
| Databáze: | OpenAIRE |
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