Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma. Issue 8 (23rd August 2019)

• Record Type: Journal Article
• Authors: Gong, Wen-Feng; Zhong, Jian-Hong; Lu, Zhan; Zhang, Qiu-Ming; Zhang, Zhi-Yuan; Chen, Chang-Zhi; Liu, Xu; Ma, Liang; Zhang, Zhi-Ming; Xiang, Bang-De; Li, Le-Qun
• Is Part Of: Bioscience reports. Volume 39:Issue 8(2019)
• Publication Date: 2019-08-23
• Subjects: HCC -- hepatectomy -- liver function -- liver regeneration -- liver volume; Molecular biology -- Periodicals; Cytology -- Periodicals; 572.8
• DOI: 10.1042/BSR20190088
• Languages: English
• ISSNs: 0144-8463

Abstract

Abstract: Aim: To explore clinical factors associated with extent of liver regeneration after hemihepatectomy to treat hepatocellular carcinoma (HCC). Methods: Future liver remnant volume (as a percentage of functional liver volume, %FLRV) and remnant liver volume were measured preoperatively and at 1, 5, 9, and 13 weeks postoperatively. Results: After hepatectomy, 1 of 125 patients (0.8%) died within 3 months, 13 (10.4%) experienced liver failure, and 99 (79.2%) experienced complications. %FLRV was able to predict liver failure with an area under the receiver operating characteristic curve of 0.900, and a cut-off value of 42.7% showed sensitivity of 85.7% and specificity of 88.6%. Postoperative median growth ratio was 21.3% at 1 week, 30.9% at 5 weeks, 34.6% at 9 weeks, and 37.1% at 13 weeks. Multivariate analysis identified three predictors associated with liver regeneration: FLRV < 601 cm 3, %FLRV, and liver cirrhosis. At postoperative weeks (POWs) 1 and 5, liver function indicators were significantly better among patients showing high extent of regeneration than among those showing low extent, but these differences disappeared by POW 9. Conclusions: FLRV, %FLRV, and liver cirrhosis strongly influence extent of liver regeneration after hepatectomy. %FLRV values below 42.7% are associated with greater risk of post-hepatectomy liver failure.