Model for end-stage liver disease (MELD) score, as a prognostic factor for post-operative morbidity and mortality in cirrhotic patients, undergoing hepatectomy for hepatocellular carcinoma
Corresponding Author
Spiros G. Delis
Division of Liver and GI Transplantation, University of Miami Miller School of Medicine, Miami, FL, USA,
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Spiros Delis, Kostantopouleio-Agia Olga Hospital, 3-5 Agias Olgas str., 142 33 Athens, Greece. Tel: 30 6973 409712; Fax: 30 210 2793969; E-mail: [email protected]Search for more papers by this authorAndreas Bakoyiannis
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorIoannis Biliatis
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorKonstantinos Athanassiou
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorNikos Tassopoulos
First Department of Medicine, Western Attica Gen. Hospital, Athens, Greece
Search for more papers by this authorChristos Dervenis
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorCorresponding Author
Spiros G. Delis
Division of Liver and GI Transplantation, University of Miami Miller School of Medicine, Miami, FL, USA,
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Spiros Delis, Kostantopouleio-Agia Olga Hospital, 3-5 Agias Olgas str., 142 33 Athens, Greece. Tel: 30 6973 409712; Fax: 30 210 2793969; E-mail: [email protected]Search for more papers by this authorAndreas Bakoyiannis
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorIoannis Biliatis
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorKonstantinos Athanassiou
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorNikos Tassopoulos
First Department of Medicine, Western Attica Gen. Hospital, Athens, Greece
Search for more papers by this authorChristos Dervenis
Liver surgical unit, 1st Surgical Department, Kostantopouleio-‘Agia Olga’ Hospital, and
Search for more papers by this authorAbstract
Background/aims: To evaluate the ability of the model for end-stage liver disease (MELD) in predicting the post-hepatectomy outcome for hepatocellular carcinoma (HCC).
Methods: Between 2001 and 2004, 69 cirrhotic patients with HCC underwent hepatectomy and the results were retrospectively analysed. MELD score was associated with post-operative mortality and morbidity, hospital stay and 3-year survival.
Results: Seventeen major and 52 minor resections were performed. Thirty-day mortality rate was 7.2%. MELD ≤ 9 was associated with no peri-operative mortality vs. 19% when MELD > 9 (P < 0.02). Overall morbidity rate was 36.23%; 48% when MELD > 9 vs. 25% when MELD ≤ 9 (P < 0.02). Median hospital stay was 12 days [8.8 days, when MELD ≤ 9 and 15.6 days when MELD > 9 (P = 0.037)]. Three-year survival reached 49% (66% when MELD ≤ 9; 32% when MELD > 9 (P < 0.01). In multivariate analysis, MELD > 9 (P < 0.01), clinical tumour symptoms (P < 0.05) and American Society of Anesthesiologists (ASA) score (P < 0.05) were independent predictors of peri-operative mortality; MELD > 9 (P < 0.01), tumour size >5 cm (P < 0.01), high tumour grade (P = 0.01) and absence of tumour capsule (P < 0.01) were independent predictors of decreased long-term survival.
Conclusion: MELD score seems to predict outcome of cirrhotic patients with HCC, after hepatectomy.
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