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Perioperative Risk Assessment for Hepatocellular Carcinoma by Using the MELD Score

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background/aims

The aim of this study was to evaluate the ability of Model for End-Stage Liver Disease (MELD) in predicting post hepatectomy outcome for hepatocellular carcinoma (HCC).

Methods

Between 2001 and 2005, 94 cirrhotic patients with HCC underwent hepatectomy and were analyzed retrospectively. MELD score associated with postoperative mortality and morbidity, hospital stay, and 3-year survival.

Results

Twenty-eight major and 66 minor resections were performed. Thirty-day mortality rate was 6.4%. MELD ≤ 9 was associated with no perioperative mortality vs 15.3% when MELD > 9 (p = 0.01). Overall morbidity rate was 32%; 21% when MELD ≤ 9 vs 42% when MELD > 9 (p = 0.01). Median hospital stay was 11 days (7 days, when MELD ≤ 9 and 14 days when MELD > 9; p = 0.03). Three-year survival reached 48% (63% when MELD ≤ 9; 30% when MELD > 9; p < 0.01). In multivariate analysis, MELD > 9 (p = 0.01), clinical tumor symptoms (p = 0.04), and American Society of Anesthesiologists score (p = 0.04) were independent predictors of perioperative mortality; MELD > 9 (p = 0.01), tumor size >5 cm (p = 0.01), presence of tumor symptoms (p = 0.02), high tumor grade (p = 0.01), and absence of tumor capsule (p = 0.01) were independent predictors of decreased long-term survival.

Conclusion

MELD score seems to predict outcome of cirrhotic patients with HCC after hepatectomy.

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Conflict of interest statement

All authors declare to have no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.

The authors: Spiros G Delis, Andreas Bakoyiannis, Nikos Tassopoulos, Christos Dervenis.

Role of the funding source

All authors declare that no sponsors had any involvement in the study.

The authors: Spiros G Delis, Andreas Bakoyiannis, Nikos Tassopoulos, Christos Dervenis.

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Authors and Affiliations

  1. Division of Liver and GI Transplantation, University of Miami Miller School of Medicine, Miami, FL, 33136, USA

    Spiros G. Delis

  2. Liver Surgical Unit, 1st Surgical Department, Kostantopouleio-“Agia Olga” Hospital, 3-5 Agias Olgas str., 142 33, Athens, Greece

    Spiros G. Delis, Andreas Bakoyiannis & Christos Dervenis

  3. First Department of Medicine, Western Attica Gen. Hospital, Athens, Greece

    Nikos Tassopoulos

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  1. Spiros G. Delis
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Correspondence to Spiros G. Delis.

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Delis, S.G., Bakoyiannis, A., Dervenis, C. et al. Perioperative Risk Assessment for Hepatocellular Carcinoma by Using the MELD Score. J Gastrointest Surg 13, 2268–2275 (2009). https://doi.org/10.1007/s11605-009-0977-5

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  • DOI: https://doi.org/10.1007/s11605-009-0977-5

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