The preoperative fibrosis score 4 predicts posthepatectomy liver failure in patients with hepatocellular carcinoma

Ann Hepatol. 2019 Sep-Oct;18(5):701-707. doi: 10.1016/j.aohep.2019.04.017. Epub 2019 May 26.

Abstract

Introduction and objectives: The fibrosis score 4 (FIB-4) has been identified as a biochemical surrogate for histological fibrogenesis and fibrosis in cirrhosis. This study investigates the impact of preoperative FIB-4 on postoperative liver failure of patients with hepatocellular carcinoma (HCC).

Materials and methods: Data from 205 patients who underwent curative resection for HCC were retrospectively analyzed. The receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of the FIB-4. Univariate analysis and multivariate analysis were performed to identify risk factors for postoperative liver failure. The clinical outcomes were compared between patients with high FIB-4 and low FIB-4.

Results: The optimal cutoff value of the FIB-4 was set at 5.92 for postoperative liver failure according to ROC curve. By univariate and multivariate analysis, the number of resected segments, FIB-4, and model for end-stage liver disease score were identified as independent risk factors for postoperative liver failure. Patients with preoperative FIB-4>5.92 had poorer liver function and higher occurrence of postoperative liver failure.

Conclusions: Preoperative FIB-4 was associated with postoperative liver failure. Patients with preoperative FIB-4>5.92 carry a high risk of postoperative liver failure.

Keywords: Liver function; Postoperative liver failure; Viral hepatitis.

MeSH terms

  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Hepatectomy / adverse effects*
  • Humans
  • Liver / pathology*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Liver Failure / diagnosis
  • Liver Failure / etiology*
  • Liver Neoplasms / complications
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index