Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade.

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Serval ID
serval:BIB_15F3592842A1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade.
Journal
PloS one
Author(s)
Kokudo T., Hasegawa K., Amikura K., Uldry E., Shirata C., Yamaguchi T., Arita J., Kaneko J., Akamatsu N., Sakamoto Y., Takahashi A., Sakamoto H., Makuuchi M., Matsuyama Y., Demartines N., Malagó M., Kokudo N., Halkic N.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
11
Number
7
Pages
e0159530
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Abstract
Most patients with hepatocellular carcinoma (HCC) have underlying liver disease, therefore, precise preoperative evaluation of the patient's liver function is essential for surgical decision making.
We developed a grading system incorporating only two variables, namely, the serum albumin level and the indocyanine green retention rate at 15 minutes (ICG R15), to assess the preoperative liver function, based on the overall survival of 1868 patients with HCC who underwent liver resection. We then tested the model in a European cohort (n = 70) and analyzed the predictive power for the postoperative short-term outcome.
The Albumin-Indocyanine Green Evaluation (ALICE) grading system was developed in a randomly assigned training cohort: linear predictor = 0.663 × log10ICG R15 (%)-0.0718 × albumin (g/L) (cut-off value: -2.20 and -1.39). This new grading system showed a predictive power for the overall survival similar to the Child-Pugh grading system in the validation cohort. Determination of the ALICE grade in Child-Pugh A patients allowed further stratification of the postoperative prognosis. This result was reproducible in the European cohort. Determination of the ALICE grade allowed better prediction of the risk of postoperative liver failure and mortality (ascites: grade 1, 2.1%; grade 2, 6.5%; grade 3, 16.0%; mortality: grade 1, 0%; grade 2, 1.3%; grade 3, 5.3%) than the previously reported model based on the presence/absence of portal hypertension.
This new grading system is a simple method for prediction of the postoperative long-term and short-term outcomes.

Keywords
Aged, Carcinoma, Hepatocellular/diagnosis, Carcinoma, Hepatocellular/mortality, Carcinoma, Hepatocellular/physiopathology, Carcinoma, Hepatocellular/surgery, Female, Hepatectomy, Humans, Indocyanine Green/pharmacokinetics, Liver/metabolism, Liver/physiopathology, Liver/surgery, Liver Function Tests, Liver Neoplasms/diagnosis, Liver Neoplasms/mortality, Liver Neoplasms/physiopathology, Liver Neoplasms/surgery, Male, Middle Aged, Neoplasm Grading, Preoperative Period, Prognosis, Prospective Studies, Serum Albumin/metabolism, Survival Analysis, Treatment Failure
Pubmed
Web of science
Open Access
Yes
Create date
24/07/2016 14:24
Last modification date
20/08/2019 12:45
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