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 cm3, %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.
Highlights
Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer worldwide, as well as the third leading cause of cancer mortality [1]
Inadequate future liver remnant volume (FLRV) can lead to post-hepatectomy liver failure (PHLF), which is a major cause of morbidity and mortality [3]
The present study examined liver regeneration growth ratios and extent of regeneration at different times after hemihepatectomy in HCC patients
Summary
Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer worldwide, as well as the third leading cause of cancer mortality [1]. The primary curative option for HCC patients, can remarkably improve overall survival [2], but it should be performed only when the remaining liver can provide sufficient function. Inadequate future liver remnant volume (FLRV) can lead to post-hepatectomy liver failure (PHLF), which is a major cause of morbidity and mortality [3]. The course of regeneration and what clinical factors may influence it are poorly understood, in part since previous studies have focused largely on liver progenitor cells [10] and animal models [11]. Few studies have examined patients for the purpose of clarifying when and how post-hepatectomy liver regeneration occurs
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
