IF 2.4 3区医学

Hpb Pub Date : 2026-05-01 Epub Date: 2026-01-17 DOI: 10.1016/j.hpb.2026.01.006

Nikhil Suresh, Shahid Farid, Peter Lodge

引用次数: 0

Clinical trials for hepatocellular carcinoma: are we reaching the most vulnerable patients? 肝细胞癌的临床试验：我们是否覆盖了最脆弱的患者？

IF 2.4 3区医学

Hpb Pub Date : 2026-04-17 DOI: 10.1016/j.hpb.2026.04.448

Xiang Gao, Shruthi R Perati, Sana M Mohayya, Ernie Shippey, Henry A Pitt, Mariam F Eskander

{"title":"Clinical trials for hepatocellular carcinoma: are we reaching the most vulnerable patients?","authors":"Xiang Gao, Shruthi R Perati, Sana M Mohayya, Ernie Shippey, Henry A Pitt, Mariam F Eskander","doi":"10.1016/j.hpb.2026.04.448","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.04.448","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is more common in vulnerable populations, but the impact of social vulnerability on clinical trial participation remains unclear.</p><p><strong>Methods: </strong>Adults with a diagnosis of HCC between 2019 and 2023 in the United States-based Vizient Clinical Database were analyzed. Univariate and multivariable analyses evaluated the association between the Vizient Vulnerability Index (VVI), a census track level measure of social vulnerability, and clinical trial participation. Interaction tests were performed for race/ethnicity and VVI.</p><p><strong>Results: </strong>Among 201,704 HCC patients, 2.1% participated in a clinical trial. Participants were more often White (57% vs 53%), commercially insured (27% vs 22%), had MELD-Na<10 (10% vs 5%), and metabolic liver disease (28% vs 18%), all p < 0.0001. Lower odds of enrollment were observed in patients identifying as Black (OR 0.80) or Hispanic (OR 0.82), on Medicaid (OR 0.69), receiving care at a community hospital (OR 0.41), and residing in the most vulnerable census tracts (OR 0.87); all p < 0.001. High social vulnerability in healthcare access, neighborhood resources, and transportation was associated with lower participation (all p < 0.0001).</p><p><strong>Conclusion: </strong>HCC patients who live in socially vulnerable communities are less likely to participate in clinical trials. Social vulnerability has a disproportionate impact on trial enrollment for Black and Hispanic patients.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep learning via pathology-image integration for margin prediction after pancreatoduodenectomy. 基于病理图像整合的深度学习用于胰十二指肠切除术后边缘预测。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-16 DOI: 10.1016/j.hpb.2026.04.445

Ansley B Ricker, Sagar Satyanarayana, Trenton Pritt, Stephanie Jensen, Katheryn Peterson, Rohit Mantha, Allyson Cochran, John B Martinie, Erin H Baker

{"title":"Deep learning via pathology-image integration for margin prediction after pancreatoduodenectomy.","authors":"Ansley B Ricker, Sagar Satyanarayana, Trenton Pritt, Stephanie Jensen, Katheryn Peterson, Rohit Mantha, Allyson Cochran, John B Martinie, Erin H Baker","doi":"10.1016/j.hpb.2026.04.445","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.04.445","url":null,"abstract":"<p><strong>Introduction: </strong>R1 margin status after pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) remains common and is associated with inferior survival. Preoperative imaging inadequately predicts microscopic margin involvement, particularly at the superior mesenteric artery interface. This study evaluated whether deep learning applied to preoperative CT imaging could predict pathological margin status.</p><p><strong>Methods: </strong>Patients who underwent PD for PDAC between 2007-2021 were identified from a prospectively maintained database. Preoperative triphasic CT scans were processed into standardized axial slices and labeled according to pathological margin status. Two convolutional neural network models were developed using an attention-based multiple instance learning approach. Model 1 used all slices from each CT scan. Model 2 incorporated noise-reduction techniques, including selective slice extraction, grayscale normalization, artifact removal, and cropping to the pancreas and surrounding tissue.</p><p><strong>Results: </strong>One hundred patients met inclusion criteria (50 R0, 50 R1/R2), yielding 14,445 CT slices. Model 1 achieved an AUC of 0.69. After noise reduction, Model 2 demonstrated improved performance with an AUC of 0.78 and 88.2% sensitivity for identifying margin-positive cases.</p><p><strong>Conclusion: </strong>Deep learning applied to preoperative CT imaging shows feasibility for predicting pathological margin status after PD. Noise-reduction preprocessing improved performance, supporting imaging in preoperative risk stratification and surgical planning.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safe major hepatectomy in HCC patients with remnant-to-standard liver volume below 40% and preserved ICG clearance. 残肝容量低于标准肝容量40%并保留ICG清除率的HCC患者的安全大肝切除术。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-15 DOI: 10.1016/j.hpb.2026.04.446

Viet Q Dang, Phu H Pham, Thinh Q Vo, Thanh Q Nguyen, Hung Q Ha, Bac H Nguyen

{"title":"Safe major hepatectomy in HCC patients with remnant-to-standard liver volume below 40% and preserved ICG clearance.","authors":"Viet Q Dang, Phu H Pham, Thinh Q Vo, Thanh Q Nguyen, Hung Q Ha, Bac H Nguyen","doi":"10.1016/j.hpb.2026.04.446","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.04.446","url":null,"abstract":"<p><strong>Background: </strong>A future liver remnant (FLR) ≥40% is commonly recommended for major hepatectomy in patients with chronic liver disease; however, volumetry alone may not adequately reflect functional reserve. We evaluated whether FLR <40% increases posthepatectomy liver failure (PHLF) in hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>This retrospective study included 269 consecutive patients who underwent major hepatectomy for HCC between October 2016 and December 2024. Patients were stratified into FLR <40% (n = 84) and FLR ≥40% (n = 185). Clinically relevant PHLF was defined as ISGLS grade B-C, and liver failure was also assessed using the 50-50 criteria. Propensity score matching (1:2) and inverse probability of treatment weighting (IPTW) were performed.</p><p><strong>Results: </strong>ISGLS grade B-C PHLF occurred more frequently in the FLR <40% group in unadjusted (13.1% vs 3.8%), matched (15.9% vs 1.7%), and IPTW analyses (16.4% vs 3.5%). In contrast, liver failure defined by the 50-50 criteria did not differ between groups. Postoperative mortality and length of hospital stay were comparable.</p><p><strong>Conclusion: </strong>FLR <40% is associated with increased ISGLS-defined PHLF but not with PHLF defined by the 50-50 criteria, mortality, or prolonged hospitalization in patients with preserved functional reserve.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors, timing, and outcomes of Clostridium difficile infection following liver and pancreatic resection. 肝脏和胰腺切除术后艰难梭菌感染的预测因素、时间和结果。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-15 DOI: 10.1016/j.hpb.2026.04.447

Qaidar Alizai, Odysseas P Chatzipanagiotou, Charalampos M Charalampous, Areesh Mevawalla, Meher Angez, Rida Ejaz, Abdulaziz Elemosho, Sebastian Ekenze, Timothy M Pawlik

{"title":"Predictors, timing, and outcomes of Clostridium difficile infection following liver and pancreatic resection.","authors":"Qaidar Alizai, Odysseas P Chatzipanagiotou, Charalampos M Charalampous, Areesh Mevawalla, Meher Angez, Rida Ejaz, Abdulaziz Elemosho, Sebastian Ekenze, Timothy M Pawlik","doi":"10.1016/j.hpb.2026.04.447","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.04.447","url":null,"abstract":"<p><strong>Background: </strong>Clostridium difficile infection (CDI) is a common healthcare-associated infection. We assessed the incidence, timing, risk factors, and outcomes of CDI following liver and pancreatic resection.</p><p><strong>Methods: </strong>Adults undergoing elective hepatic or pancreatic resection were identified in ACS-NSQIP (2015-2021). The primary exposure was 30-day postoperative CDI. Outcomes included 30-day mortality, non-home discharge, unplanned readmission, and length of stay (LOS). Multivariable regression analyses were conducted.</p><p><strong>Results: </strong>Among 76,083 patients (liver: 30,145 [39.6%], pancreas: 45,938 [60.4%]), 860 (1.1%) developed CDI, including 236 hepatic and 624 pancreatic cases. Overall, 44.8% occurred within the first postoperative week. Patients with CDI were more often aged ≥75 years, ASA III-V, on preoperative dialysis, and had CHF (all p<0.05). Following hepatic resection, CDI was associated with increased mortality (aOR 3.64, 95%CI 1.60-8.28), readmission (aOR 2.78, 95%CI 2.00-3.85), and longer LOS (+3.25 days, 95%CI 2.82-3.68). Following pancreatic resection, CDI was associated with readmission (aOR 2.29, 95%CI 1.89-2.78) and prolonged LOS (+3.00 days, 95%CI 2.76-3.24).</p><p><strong>Discussion: </strong>CDI occurred in 1.1% of HP surgery patients, nearly half within the first postoperative week, and was associated with worse outcomes. Early identification of high-risk patients may improve prevention and management.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pancreatic enzyme replacement therapy for prevention of postpancreatectomy hepatic steatosis after pancreatoduodenectomy: a post hoc analysis of a randomized placebo-controlled trial. 胰酶替代疗法预防胰十二指肠切除术后肝脂肪变性：一项随机安慰剂对照试验的事后分析

IF 2.4 3区医学

Hpb Pub Date : 2026-04-04 DOI: 10.1016/j.hpb.2026.03.008

Moonhwan Kim, Yoo-Seok Yoon, Jin-Young Jang, Wooil Kwon, Hongbeom Kim, Dong-Sup Yoon, Joon S Park, Seung E Lee, Jun S Lee, Ho-Seong Han

{"title":"Pancreatic enzyme replacement therapy for prevention of postpancreatectomy hepatic steatosis after pancreatoduodenectomy: a post hoc analysis of a randomized placebo-controlled trial.","authors":"Moonhwan Kim, Yoo-Seok Yoon, Jin-Young Jang, Wooil Kwon, Hongbeom Kim, Dong-Sup Yoon, Joon S Park, Seung E Lee, Jun S Lee, Ho-Seong Han","doi":"10.1016/j.hpb.2026.03.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.03.008","url":null,"abstract":"<p><strong>Background: </strong>Postpancreatectomy hepatic steatosis (PHS) is a long-term complication after pancreaticoduodenectomy (PD). We investigated the association between PERT and the development of PHS.</p><p><strong>Methods: </strong>Among patients randomized to PERT or placebo after PD in a previous prospective study (NCT02127021), 94 patients with preoperative and 1-year postoperative unenhanced computed tomography (CT) were included. PHS was defined as liver attenuation of <40 Hounsfield units (HU) or liver-to-spleen attenuation difference of ≥10 HU on non-contrast CT.</p><p><strong>Results: </strong>The PERT group contained 42 patients and the placebo group contained 52 patients. The incidence of PHS at 1 year was significantly lower in the PERT group compared with the placebo group (9.5% vs. 23.1%, p < 0.001). Independent risk factors in the multivariable analysis were placebo intake (OR 2.376, p < 0.001) and body weight loss of >5% at 3 months postoperatively (OR 1.602, p = 0.046). Subgroup analysis confirmed that PERT consistently reduced the incidence of PHS in patient with body weight loss of >5% after 3 months of medication administration.</p><p><strong>Conclusions: </strong>PERT was associated with a significantly lower incidence of PHS after PD than placebo, with sustained benefits in patients with significant postoperative body weight loss.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Liver transplant for combined hepatocellular-cholangiocarcinoma: United States outcomes and influence of the MMaT-3 policy. 肝细胞-胆管合并癌的肝移植：美国MMaT-3政策的结果和影响

IF 2.4 3区医学

Hpb Pub Date : 2026-04-03 DOI: 10.1016/j.hpb.2026.03.010

Leandro Sierra, Clive J Miranda, Maria O Abad, Butros Fakhoury, Maria Saavedra-Martinez, Ahmed Al-Hindawi, Eyad Abdulrazzak, Pojsakorn Danpanichkul, Tzu-Hao Lee, Nikki Duong, Sandeep Mukherjee

{"title":"Liver transplant for combined hepatocellular-cholangiocarcinoma: United States outcomes and influence of the MMaT-3 policy.","authors":"Leandro Sierra, Clive J Miranda, Maria O Abad, Butros Fakhoury, Maria Saavedra-Martinez, Ahmed Al-Hindawi, Eyad Abdulrazzak, Pojsakorn Danpanichkul, Tzu-Hao Lee, Nikki Duong, Sandeep Mukherjee","doi":"10.1016/j.hpb.2026.03.010","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.03.010","url":null,"abstract":"<p><strong>Introduction: </strong>There is absence of updated population-level data for liver transplantation (LT) for combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and on the impact of current allocation practices, including the Median MELD at Transplant minus 3 (MMaT-3) policy era.</p><p><strong>Methods: </strong>Using the UNOS registry, we compared adult LT candidates and recipients with cHCC-CCA, hepatocellular carcinoma (HCC), and cholangiocarcinoma (CCA). Outcomes included waitlist mortality (WM), waitlist dropout (WD), graft survival (GS), and patient survival (PS), analyzed using Kaplan-Meier, multivariable Cox regression, and Fine-Gray competing risk models stratified by policy era.</p><p><strong>Results: </strong>309 candidates had cHCC-CCA. At 3 years, cHCC-CCA had the lowest WM (4.6%) and WD (29.0%) compared with CCA (27.7%, 64.9%) and HCC (15.6%, 39.8%) (P < 0.001). After adjustment, cHCC-CCA was associated with reduced WD (HR 0.56, P = 0.008) and WM (HR 0.33, P = 0.028). Conversely, 15-year GS (25.5%) and PS (27.3%) were lowest for cHCC-CCA (both P < 0.001), with higher adjusted risk of graft loss (HR 1.79) and mortality (HR 1.67). Notably, cHCC-CCA post-LT survival improved from the pre-MMaT-3 to the post-MMaT-3 era.</p><p><strong>Conclusion: </strong>cHCC-CCA exhibits favorable waitlist, yet lower long-term post-LT survival compared with HCC and CCA. The improved outcomes observed in the MMaT-3 era suggest that refined selection may have optimized post-LT survival in cHCC-CCA.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Textbook outcomes for robotic liver resection: assessing relevant clinical variables. 机器人肝切除术的教科书结果：评估相关临床变量。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-02 DOI: 10.1016/j.hpb.2026.03.009

E Giuseppe, M C Kristina, R Sharona, A Hasan, M Melanie, P Pietro, O Roberta, V Garnet, S Iswanto

{"title":"Textbook outcomes for robotic liver resection: assessing relevant clinical variables.","authors":"E Giuseppe, M C Kristina, R Sharona, A Hasan, M Melanie, P Pietro, O Roberta, V Garnet, S Iswanto","doi":"10.1016/j.hpb.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2026.03.009","url":null,"abstract":"<p><strong>Background: </strong>Textbook outcome (TO) is a multidimensional metric for assessing surgical success, integrating several postoperative variables into a single composite endpoint. While TO definitions have been validated for open and laparoscopic liver resections (LR), no consensus exist for the robotic approach. This retrospective study assesses TO and extended-TO (TOLS+) in patients undergoing robotic LR, and explores perioperative factors associated with TO-achievement.</p><p><strong>Methods: </strong>We analyzed 622 consecutive robotic LR for benign and malignant disease between 2013 and 2024. TO and TOLS+ were defined according to a global expert Delphi consensus in 2023. Logistic regression analyses were conducted to identify TO-achievement predictors.</p><p><strong>Results: </strong>Among 546 patients, 488 (89.4%) achieved TO and 358 (65.6%) met TOLS + criteria. Non-TO patients exhibited longer operative times (315.2 ± 147.4 vs. 267.3 ± 121.5 min, p = 0.0141), higher estimated blood loss (254.9 ± 300.7 vs. 165.3 ± 186.7 mL, p = 0.0193), higher rates of unplanned conversion (5.2% vs. 0.4%, p = 0.0098), and ICU admission (29.8% vs. 2.9%, p < 0.0001). TO was significantly associated with history of myocardial infarction, ICU admission, and prolonged LOS.</p><p><strong>Conclusion: </strong>Robotic LR achieved high TO and TOLS + rates within our cohort. These findings underscore the role of robotic platforms in promoting optimal surgical outcomes in high-volume centers.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of subtotal cholecystectomy from a large tertiary New Zealand hospital 新西兰一家大型三级医院胆囊次全切除术的结果。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-17 DOI: 10.1016/j.hpb.2025.12.029

Hannah Kim , Jing Goh , Isaac Tranter-Entwistle, Saxon Connor

{"title":"Outcomes of subtotal cholecystectomy from a large tertiary New Zealand hospital","authors":"Hannah Kim , Jing Goh , Isaac Tranter-Entwistle, Saxon Connor","doi":"10.1016/j.hpb.2025.12.029","DOIUrl":"10.1016/j.hpb.2025.12.029","url":null,"abstract":"<div><h3>Background</h3><div>Subtotal cholecystectomy (StC) is a recognised bail-out strategy for difficult cholecystectomy. The aim of the study was to analyse technical aspects and outcomes associated with subtypes of StC.</div></div><div><h3>Method</h3><div>All perioperative data of patients who underwent StC at Christchurch Hospital between June 2015 to September 2023 were retrospectively identified and analysed. The subtypes were classified as reconstituting (rStC), fenestrating (fStC), and remnant posterior wall (pwStC) subtotal cholecystectomy.</div></div><div><h3>Results</h3><div>Of the 6251 patients who underwent cholecystectomy, 422 (6.8 %) underwent StC, and 132 (31.3 %), 115 (27.3 %), 175 (41.5 %) underwent rStC, fStC and pwStC respectively.pwStC was generally associated with superior, and fStC inferior outcomes. In patients who had fStC, rStC and pwStC; 38 (33.0 %), 12 (9.1 %), 6 (3.4 %) developed bile leak (p < 0.001), 20 (17.4 %), 12 (9.1 %), 3 (1.7 %) developed intraabdominal collections (p < 0.001), and 28 (24.3 %), 10 (7.6 %) and 9 (5.1 %) required post-operative ERCP (p < 0.001), respectively. No difference in rates of delayed post-op biliary events including cholecystitis and choledocholithiasis were noted across the subgroups (p = 0.775).</div></div><div><h3>Conclusion</h3><div>There are technical variations of StC with different complication profiles. Surgeons should be aware of these nuances, as it may help inform decision making when faced with need to perform StC.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 534-540"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Traditional clinical predictors outperform ALBI, NLR, and PLR after curative hepatic resection for HCC in a Western cohort 在一项西方队列研究中，肝癌根治性肝切除术后的传统临床预测指标优于ALBI、NLR和PLR。

IF 2.4 3区医学

Hpb Pub Date : 2026-04-01 Epub Date: 2026-01-07 DOI: 10.1016/j.hpb.2025.12.038

Berkay Demirors , Christopher Kaltenmeier , Abiha Abdullah , Vrishketan Sethi , Charbel Elias , Frank Spitz , Jason Mial-Anthony , Timothy Fokken , Shwe Han , Sabin Subedi , Godwin Packiaraj , Marta Minervini , Michele Molinari

{"title":"Traditional clinical predictors outperform ALBI, NLR, and PLR after curative hepatic resection for HCC in a Western cohort","authors":"Berkay Demirors , Christopher Kaltenmeier , Abiha Abdullah , Vrishketan Sethi , Charbel Elias , Frank Spitz , Jason Mial-Anthony , Timothy Fokken , Shwe Han , Sabin Subedi , Godwin Packiaraj , Marta Minervini , Michele Molinari","doi":"10.1016/j.hpb.2025.12.038","DOIUrl":"10.1016/j.hpb.2025.12.038","url":null,"abstract":"<div><h3>Background</h3><div>Oncological characteristics and underlying liver function influence the outcomes of patients with hepatocellular carcinoma. The Albumin-Bilirubin (ALBI) score, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are predictive instruments. However, for patients undergoing hepatic resection, their value remains unclear, particularly in Western populations.</div></div><div><h3>Methods</h3><div>ALBI, NLR and PLR were derived from blood tests obtained prior to surgery in 156 consecutive patients who underwent R0 hepatic resections between 2015 and 2020 at a Western academic center. Associations with overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier methods and Cox regression models.</div></div><div><h3>Results</h3><div>Median age was 60 years; 72 % of patients were male, and 45 % had underlying cirrhosis. On univariate analysis, ALBI grade was associated with OS and PFS and NLR with OS, but neither retained significance in multivariate models. PLR was not predictive. Cirrhosis (HR 2.32), ECOG performance status ≥2 (HR 2.67), and AFP >100 ng/mL (HR 2.89) were independently associated with worse OS in multivariate analysis. Tumor number ≥2 and AFP >100 ng/mL were two independent predictors for PFS.</div></div><div><h3>Conclusion</h3><div>ALBI, NLR and PLR did not emerge as clinically relevant predictive value for OS and PFS in patients undergoing resection for HCC.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"28 4","pages":"Pages 565-573"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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