Study on the clinical value of three different scoring systems in assessing peri-operative period risk for HCC patients undergoing hepatectomy

Abstract

Objective To compare the clinical value of Child-Pugh, model for end-stage liver disease (MELD) and chronic liver dsyfunction score (CLD) in assessing peri-operative period risk for HCC patients who underwent hepatectomy. Methods One hundred and forty-one cases with hepatocellular carcinoma were retrospectively analyzed. Before the operation, the Child-Pugh classification, MELD score, and CLD score were calculated. Analysis of the relationship between postoperative liver dysfunction rate and the three kinds of evaluation methods were conducted. Results ①The postoperative liver dysfunction rate of Child-Pugh class A and class B showed no significant difference, while the differences of the rate between MELD≤14 and >14 as well as CLD≤ 1 and >1 were both significant (χ2=10.187, 12.322, P<0.05). ② There was no significant difference in Child-Pugh score between liver well recovered group and mildly insufficient group. MELD score and CLD score of the well recovered group, mild insufficiency group and severe insufficiency group increased, with a significant difference (P<0.05). ③ The ROC-AUC of CLD score, MELD score and Child-Pugh increased in order and the difference was statistically significant (P<0.05). ④When specific degree was 95%, the sensitivity of CLD was the highest, followed by MELD, and Child-Pugh was the lowest (P<0.05). Conclusion Compared with Child-Pugh which is widespreadly used currently, MELD and CLD score systems both show the ability of predicting liver dysfunction, and the accuracy and sensitivity of CLD is better than MELD. Key words: Liver resection; End stage liver disease; Chronic liver dysfunction score; Child-Pugh classification