Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2023; 14(11): 459-470
Published online Nov 24, 2023. doi: 10.5306/wjco.v14.i11.459
Clinical study of standard residual liver volume and transient elastography in predicting poor prognosis of patients after hemihepatectomy
Zhi-Qiang Yue, Peng Zhang, Shuai Yan, Lin-Ling Ju, Hui-Xuan Wang, Liu-Xia Yuan, Lin Chen, Jin-Zhu Wu, Ya-Li Cao
Zhi-Qiang Yue, Shuai Yan, Medical School of Nantong University, Nantong Third People’s Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226000, Jiangsu Province, China
Peng Zhang, Jin-Zhu Wu, Department of Hepatobiliary Surgery, Nantong Third People’s Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226000, Jiangsu Province, China
Lin-Ling Ju, Hui-Xuan Wang, Liu-Xia Yuan, Lin Chen, Nantong Institute of Liver Disease, Nantong Third People’s Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226000, Jiangsu Province, China
Ya-Li Cao, Preventive Health Department, Nantong Third People’s Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226000, Jiangsu Province, China
Co-first authors: Zhi-Qiang Yue and Peng Zhang.
Co-corresponding authors: Jin-Zhu Wu and Ya-Li Cao.
Author contributions: Yue ZQ, Zhang P, Yan S, Yuan LX, Ju LL, Wang HX, Chen L, Cao YL and Wu JZ contributed equally to this work; Yue ZQ, Zhang P, Yan S, Yuan LX and Wu JZ were hepatobiliary surgeons; Ju LL, Wang HX, Yuan LX, Chen L and Cao YL were researchers in Nantong Institute of Liver Disease; Wu JZ, Chen L, Cao YL designed the research study; Yue ZQ, Zhang P, Yan S, Yuan LX, Ju LL and Wang HX performed the primary literature and data extraction; Yue ZQ, Zhang P analyzed the data and wrote the manuscript; Chen L, Cao YL and Wu JZ were responsible for revising the manuscript for important intellectual content; and all authors read and approved the final version. Yue ZQ and Zhang P have made equally significant contributions to this thesis. In accordance with the principles of rigorous and objective research and respect for the contributions of all team members, Zhang P is co-designated as the first author. Wu JZ (corresponding author) and Cao YL (co-corresponding author) provided financial support for this research. Wu JZ (corresponding author), as the research advisor of Yue ZQ (first author), was primarily responsible for the design and guidance of the paper. Meanwhile, Cao YL (co-corresponding author), as an authoritative expert, significantly contributed to the advancement of this study. Therefore, Cao YL is co-designated as the co-corresponding author.
Supported by Nantong Municipal Health Commission, No. MSZ2022036 and No. QN2022041; Nantong Science and Technology Bureau, No. JCZ2022036.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Nantong Third People’s Hospital (approval NO. EK201628).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 39235978@qq.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Zhu Wu, MMed, Associate Chief Physician, Department of Hepatobiliary Surgery, Nantong Third People’s Hospital, Affiliated Nantong Hospital 3 of Nantong University, No. 60 Qingnian Middle Road, Chongchuan District, Nantong 226000, Jiangsu Province, China. 39235978@qq.com
Received: September 4, 2023
Peer-review started: September 4, 2023
First decision: September 19, 2023
Revised: September 28, 2023
Accepted: October 16, 2023
Article in press: October 16, 2023
Published online: November 24, 2023
Processing time: 78 Days and 13.7 Hours
Abstract
BACKGROUND

Liver cancer resection, especially in patients with hemihepatectomy or extended hemihepatectomy, often leads to poor prognosis, such as liver insufficiency and even liver failure and death, because the standard residual liver volume (SRLV) cannot be fully compensated after surgery.

AIM

To explore the risk factors of poor prognosis after hemihepatectomy for hepatocellular carcinoma and evaluate the application value of related prognostic approaches.

METHODS

The clinical data of 35 patients with primary liver cancer in Nantong Third People's Hospital from February 2016 to July 2020 were retrospectively analyzed. The receiver operating characteristic curve was created using medcac19.0.4 to compare the critical values of the SRLV in different stages of liver fibrosis after hemihepatectomy with those of liver dysfunction after hemihepatectomy. It was constructed by combining the Child-Pugh score to evaluate its application value in predicting liver function compensation.

RESULTS

The liver stiffness measure (LSM) value and SRLV were associated with liver dysfunction after hemihepatectomy. Logistic regression analysis showed that an LSM value ≥ 25 kPa [odds ratio (OR) = 6.254, P < 0.05] and SRLV ≤ 0.290 L/m2 (OR = 5.686, P < 0.05) were independent risk factors for postoperative liver dysfunction. The accuracy of the new liver reserve evaluation model for predicting postoperative liver function was higher than that of the Child-Pugh score (P < 0.05).

CONCLUSION

SRLV and LSM values can be used to evaluate the safety of hemihepatectomy. The new liver reserve evaluation model has good application potential in the evaluation of liver reserve function after hemihepatectomy.

Keywords: Hepatocellular carcinoma; Hemihepatectomy; Prognosis; Standard residual liver volume; Liver stiffness measure value

Core Tip: To explore the risk factors and predictive methods of poor prognosis after hemihepatectomy for hepatocellular carcinoma and evaluate its application value. The clinical data of 35 patients with primary liver cancer were retrospectively analyzed. The critical values of standard residual liver volume (SRLV) in different stages of liver fibrosis after hemihepatectomy were compared with those of liver dysfunction after hemihepatectomy. We found that SRLV and liver stiffness measure values can be used to evaluate the safety of hemihepatectomy.