Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis

Alessandro Cucchetti, Giorgio Ercolani, Marco Vivarelli, Matteo Cescon, Matteo Ravaioll, Giuliano La Barba, Matteo Zanello, Gian Luca Grazi, Antonio Daniele Pinna

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Abstract

The objective of this study was to predict postoperative liver failure and morbidity after hepatectomy for hepatocellular carcinoma (HCC) with cirrhosis. The model for end-stage liver disease (MELD) score is currently accepted as a disease severity index of cirrhotic patients awaiting liver transplantation; however, its impact on prognosis after resection of HCC on cirrhosis has never been investigated. One hundred fifty-four cirrhotic patients resected in a tertiary care setting for HCC were retrospectively analyzed. For each patient, the MELD score was calculated and related to postoperative liver failure and complications (morbidity). Hospital stay and 1-year survival was also investigated. MELD accuracy in predicting postoperative liver failure and morbidity of cirrhotic patients was assessed using receiver operating characteristic (ROC) analysis. Eleven patients (7.1 %) experienced postoperative liver failure leading to death or transplantation. ROC analysis identified cirrhotic patients with a MELD score equal to or above 11 at high risk for postoperative liver failure (area under the curve [AUC] = 0.92, 95% confidence interval [CI] = 0.87-0.96; sensitivity = 82%; specificity = 89%). Forty-six patients (29.9%) developed at least 1 postoperative complication: ROC analysis identified patients with a MELD score equal to or above 9 at major risk for postoperative complications (AUC = 0.85, 95% Cl = 0.78-0.89; sensitivity = 87%; specificity = 63%). Cirrhotic patients with MELD score below 9 had no postoperative liver failure and low morbidity (8.1 %). In conclusion, the MELD score can accurately predict postoperative liver failure and morbidity of cirrhotic patients referred for resection of HCC and should be used to select the best candidates for hepatectomy.

Original languageEnglish
Pages (from-to)966-971
Number of pages6
JournalLiver Transplantation
Volume12
Issue number6
DOIs
Publication statusPublished - Jun 2006

Fingerprint

End Stage Liver Disease
Hepatectomy
Hepatocellular Carcinoma
Fibrosis
Liver Failure
Morbidity
ROC Curve
Area Under Curve
Tertiary Healthcare
Liver Transplantation
Length of Stay
Transplantation
Confidence Intervals

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Cucchetti, A., Ercolani, G., Vivarelli, M., Cescon, M., Ravaioll, M., La Barba, G., ... Pinna, A. D. (2006). Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. Liver Transplantation, 12(6), 966-971. https://doi.org/10.1002/lt.20761

Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. / Cucchetti, Alessandro; Ercolani, Giorgio; Vivarelli, Marco; Cescon, Matteo; Ravaioll, Matteo; La Barba, Giuliano; Zanello, Matteo; Grazi, Gian Luca; Pinna, Antonio Daniele.

In: Liver Transplantation, Vol. 12, No. 6, 06.2006, p. 966-971.

Research output: Contribution to journalArticle

Cucchetti, A, Ercolani, G, Vivarelli, M, Cescon, M, Ravaioll, M, La Barba, G, Zanello, M, Grazi, GL & Pinna, AD 2006, 'Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis', Liver Transplantation, vol. 12, no. 6, pp. 966-971. https://doi.org/10.1002/lt.20761
Cucchetti, Alessandro ; Ercolani, Giorgio ; Vivarelli, Marco ; Cescon, Matteo ; Ravaioll, Matteo ; La Barba, Giuliano ; Zanello, Matteo ; Grazi, Gian Luca ; Pinna, Antonio Daniele. / Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. In: Liver Transplantation. 2006 ; Vol. 12, No. 6. pp. 966-971.
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AU - Ravaioll, Matteo

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