Scholarlink

Purpose <p>Hepatectomy is a curative treatment for hepatocellular carcinoma (HCC) but deteriorating postoperative liver function can limit its benefits, especially for patients with borderline resectable (BR) HCC. We evaluated postoperative liver function trajectories and their impact on long-term survival.</p> Methods <p>The subjects of this retrospective analysis were 790 patients who underwent initial curative hepatectomy, stratified by resectability (R, BR1, BR2) and modified albumin–bilirubin (mALBI) grade. Liver function was assessed via ALBI scores pre- and postoperatively. Deterioration was defined as an ALBI score ratio &lt; 0.9.</p> Results <p>Median overall survival (OS) differed significantly, being 109.9, 54.4, and 40.4&#xa0;months for the R, BR1, and BR2 groups, respectively (p &lt; 0.001). While functional status at POD 90 influenced recurrence-free survival, deterioration at POD 180 was identified as a robust independent predictor of OS (HR 1.53, p = 0.005). Notably, no single preoperative or perioperative factor was a significant predictor of this long-term functional decline at POD 180. Postoperative recovery was heterogeneous, with 47.5% of patients with mALBI grade 2a improving to grade 1 by POD 180.</p> Conclusions <p>Post-hepatectomy liver function at POD 180 is a key determinant of long-term survival. As this late deterioration is difficult to predict perioperatively, continuous monitoring of hepatic reserve is essential to maintain eligibility for subsequent multidisciplinary therapies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Postoperative liver function trajectories and risk factors after hepatectomy for hepatocellular carcinoma

  • 期刊论文

  • 发表日期：

    2026年6月19日

查看全文
  • Masaki Omori,
  • Shohei Komatsu,
  • Motochika Hamanaka,
  • Masahiro Kido,
  • Hidetoshi Gon,
  • Kenji Fukushima,
  • Takeshi Urade,
  • Toshihiko Yoshida,
  • Keisuke Arai,
  • Dongha Lee,
  • Masayuki Akita,
  • Takuya Mizumoto,
  • Jun Ishida,
  • Yoshihide Nanno,
  • Hiroaki Yanagimoto,
  • Takumi Fukumoto

摘要

Purpose

Hepatectomy is a curative treatment for hepatocellular carcinoma (HCC) but deteriorating postoperative liver function can limit its benefits, especially for patients with borderline resectable (BR) HCC. We evaluated postoperative liver function trajectories and their impact on long-term survival.

Methods

The subjects of this retrospective analysis were 790 patients who underwent initial curative hepatectomy, stratified by resectability (R, BR1, BR2) and modified albumin–bilirubin (mALBI) grade. Liver function was assessed via ALBI scores pre- and postoperatively. Deterioration was defined as an ALBI score ratio < 0.9.

Results

Median overall survival (OS) differed significantly, being 109.9, 54.4, and 40.4 months for the R, BR1, and BR2 groups, respectively (p < 0.001). While functional status at POD 90 influenced recurrence-free survival, deterioration at POD 180 was identified as a robust independent predictor of OS (HR 1.53, p = 0.005). Notably, no single preoperative or perioperative factor was a significant predictor of this long-term functional decline at POD 180. Postoperative recovery was heterogeneous, with 47.5% of patients with mALBI grade 2a improving to grade 1 by POD 180.

Conclusions

Post-hepatectomy liver function at POD 180 is a key determinant of long-term survival. As this late deterioration is difficult to predict perioperatively, continuous monitoring of hepatic reserve is essential to maintain eligibility for subsequent multidisciplinary therapies.