Retrospective analysis based on a clinical grading system for patients with hepatic hemangioma: A single center experience

Table 1 Determination of hepatic hemangioma grade according to the clinical grading system

Points assigned	0	1	2
Symptom	No	Mild	Obvious
Diameter (cm)	< 5	5-10	≥ 10
Location, segment	II, III, VI, VII	IV, V, VIII	I
Tumor increment (cm/year)	0	< 1	≥ 1

Table 2 Clinical characteristics and laboratory data of the patients with hepatic hemangioma

Characteristics	Score < 4		Score ≥ 4		F/χ2	P value
	Observation (n = 352)	Surgery (n = 460)	Observation (n = 77)	Surgery (n = 282)
Age (year)	46 (39, 52)	44 (39, 51)	42 (36, 54)	45 (39, 50)	0.55	0.65
HBV positive, n (%)	18 (5.11)	34 (7.39)	6 (7.79)	17 (6.03)	-	0.54
HCV positive, n (%)	3 (0.85)	1 (0.22)	0	1 (0.35)	-	0.61
Total bilirubin (μmol/L)	11.80 (9.25, 15.71)	11.76 (9.17, 15.19)	12.70 (9.42, 16.27)	11.50 (9.41, 11.51)	0.92	0.43
Albumin (g/L)	40.09 (37.63, 43)	40.95 (38, 43.9)	40 (37.65, 46.88)	40.51 (37.7, 43.51)	1.04	0.37
AST (U/L)	18.70 (15.6, 23.95)	18.20 (15.43, 22)	18 (15.3, 22.55)	18.5 (15.78, 21.9)	0.89	0.45
ALT (U/L)	17.7 (13, 25.2)	17.55 (12.85, 24.42)	16.2 (11.65, 23.2)	17.6 (12.7, 24.7)	0.46	0.71
Child-Pugh Grade A, n (%)	349 (99.15)	452 (98.26)	75 (97.40)	278 (98.58)	-	0.51
Coagulopathy (n)	0	0	0	0	-	-

HBV: Hepatitis B virus; HCV: Hepatitis C virus; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

Table 3 Comparison of outcomes during follow-up between the surgical and observation group classified by score ≥ 4 and score < 4, n (%)

	Score < 4 (n = 812)				Score ≥ 4 (n = 359)
	Observation (n = 352)	Surgery (n = 460)	χ2	P value	Observation (n = 77)	Surgery (n = 282)	χ2	P value
No abdominal complaints	308 (87.5)	430 (93.5)	8.60	0.004	34 (44.2)	274 (97.2)	-	< 0.001
Continuous or intensified or new onset of abdominal complaints	44 (12.5)	30 (6.5)			43 (55.8)	8 (2.8)
Postoperative complications	-	54 (11.7)			-	26 (9.2)
Hepatic	-	12 (2.6)			-	11 (3.9)
Extrahepatic	-	42 (9.1)			-	15 (5.3)
Need for intervention	15 (4.3)	8 (1.7)	-	0.052	31 (40.3)	5 (1.8)	-	< 0.001
Operation	1 (0.3)	1 (0.2)			2 (2.6)	2 (0.7)
TAE	5 (1.4)	2 (0.4)			27 (35.1)	3 (1.1)
RFA	9 (2.6)	5 (1.1)			2 (2.6)	0 (0)
Mortality related to hepatic hemangioma	0 (0)	0 (0)			0 (0)	2 (0.7)		-
Total patients with adverse event	48 (13.6)	78 (17.0)	1.68	0.20	45 (58.4)	34 (12.1)	-	< 0.001

More than one type of adverse outcome per patient is possible. TAE: Transcatheter arterial embolization; RFA: Radiofrequency ablation.

Table 4 Postoperative complications according to the Clavien-Dindo classification, n (%)

	Score < 4 (n = 460)	Score ≥ 4 (n = 282)
Grade I	30 (6.5)	6 (2.1)
Grade II	1 (0.2)	2 (0.7)
Grade IIIa	21 (4.6)	14 (5.0)
Grade IIIb	1 (0.2)	2 (0.7)
Grade IV	0 (0)	0 (0)
Grade V	0 (0)	2 (0.7)

Table 5 Comparison of outcomes between the observation score < 4 and surgery score ≥ 4, n (%)

	No abdominal complaints	Continuous or intensified or new onset of abdominal complaints	Postoperative complications	Need for intervention	Mortality related to hepatic hemangioma	Total patients with adverse event
Score < 4 observation (n = 352)	308 (87.5)	44 (12.5)	-	15 (4.3)	0	48 (13.6)
Score ≥ 4 surgery (n = 282)	274 (97.2)	8 (2.8)	26 (9.2)	5 (1.8)	2 (0.7)	34 (12.1)
P value	< 0.001	< 0.001	-	0.060	-	0.634