Adding liver stiffness into nomogram boosts predictive value for postoperative complications in HCC

A novel nomogram that includes liver stiffness measurements (LSM) may help predict postoperative complications in hepatocellular carcinoma (HCC) patients, a recent study has found.

Researchers retrospectively reviewed data from 471 patients (median age, 60 years; 84.3 percent male) who had undergone hepatectomy for HCC between 2006 and 2016. The comprehensive complication index (CCI) was used to quantify surgical complications, such that at or above a threshold value of 26.2, events were described as severe.

Almost a quarter (23.4 percent; n=110) of the participants developed at least one postoperative complication, and the 90-day mortality was calculated to be 0.4 percent. Around 10 percent (n=50) of the study cohort had CCI ≥26.2, and these patients tended to be older, have higher body mass index, and have more comorbidities.

Multivariable logistic regression analysis was performed, yielding a nomogram consisting of age (odds ratio [OR], 1.04, 95 percent confidence interval [CI], 1.01–1.07; p<0.005), albumin concentration (OR, 0.54, 95 percent CI, 0.30–0.97; p=0.04), score on the model for end-stage liver disease (OR, 1.20, 95 percent CI, 1.04–1.39; p=0.014), and LSM (OR, 1.04, 95 percent CI, 1.01–1.06; p=0.002).

This nomogram was internally validated and showed an optimism-corrected C-statistic value of 0.751 (95 percent CI, 0.724–0.781). After bootstrapping, the resulting area under the curve for the detection of CCI ≥26.2 was 0.7510, significantly higher than that of LSM alone.

“In conclusion, LSM, together with standard available clinical and biochemical data, may provide an excellent preoperative prediction of severe complications in patients with resectable HCC,” researchers said. “External validation of the current model will be performed in future studies.”