Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade
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...
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| Veröffentlicht in: | PloS one 2016-07, Vol.11 (7), p.e0159530-e0159530 |
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| creator | Kokudo, Takashi Hasegawa, Kiyoshi Amikura, Katsumi Uldry, Emilie Shirata, Chikara Yamaguchi, Takamune Arita, Junichi Kaneko, Junichi Akamatsu, Nobuhisa Sakamoto, Yoshihiro Takahashi, Amane Sakamoto, Hirohiko Makuuchi, Masatoshi Matsuyama, Yutaka Demartines, Nicolas Malagó, Massimo Kokudo, Norihiro Halkic, Nermin |
| description | 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. |
| doi_str_mv | 10.1371/journal.pone.0159530 |
| format | Article |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0159530</identifier><identifier>PMID: 27434062</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Albumin ; Ascites ; Biology and Life Sciences ; Carcinoma, Hepatocellular - diagnosis ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - physiopathology ; Carcinoma, Hepatocellular - surgery ; Care and treatment ; Clinical medicine ; Complications and side effects ; Decision making ; Evaluation ; Female ; Grading ; Hepatectomy ; Hepatocellular carcinoma ; Hepatology ; Hospitals ; Humans ; Hypertension ; Indocyanine Green - pharmacokinetics ; Liver ; Liver - metabolism ; Liver - physiopathology ; Liver - surgery ; Liver cancer ; Liver diseases ; Liver failure ; Liver Function Tests ; Liver Neoplasms - diagnosis ; Liver Neoplasms - mortality ; Liver Neoplasms - physiopathology ; Liver Neoplasms - surgery ; Male ; Management ; Mathematical models ; Medical imaging ; Medical prognosis ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Neoplasm Grading ; Patient outcomes ; Patients ; People and Places ; Postoperative complications ; Predictions ; Preoperative care ; Preoperative Period ; Prevention ; Prognosis ; Prospective Studies ; Quality ; Risk factors ; Serum albumin ; Serum Albumin - metabolism ; Surgery ; Surgical outcomes ; Survival ; Survival Analysis ; Systematic review ; Thrombosis ; Treatment Failure ; Veins & arteries</subject><ispartof>PloS one, 2016-07, Vol.11 (7), p.e0159530-e0159530</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Kokudo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Kokudo et al 2016 Kokudo et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-a3cac64433cd7deda991d5b739d00a353c2d84351e0ab87887cb6f6dedb308343</citedby><cites>FETCH-LOGICAL-c725t-a3cac64433cd7deda991d5b739d00a353c2d84351e0ab87887cb6f6dedb308343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951137/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951137/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27434062$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kokudo, Takashi</creatorcontrib><creatorcontrib>Hasegawa, Kiyoshi</creatorcontrib><creatorcontrib>Amikura, Katsumi</creatorcontrib><creatorcontrib>Uldry, Emilie</creatorcontrib><creatorcontrib>Shirata, Chikara</creatorcontrib><creatorcontrib>Yamaguchi, Takamune</creatorcontrib><creatorcontrib>Arita, Junichi</creatorcontrib><creatorcontrib>Kaneko, Junichi</creatorcontrib><creatorcontrib>Akamatsu, Nobuhisa</creatorcontrib><creatorcontrib>Sakamoto, Yoshihiro</creatorcontrib><creatorcontrib>Takahashi, Amane</creatorcontrib><creatorcontrib>Sakamoto, Hirohiko</creatorcontrib><creatorcontrib>Makuuchi, Masatoshi</creatorcontrib><creatorcontrib>Matsuyama, Yutaka</creatorcontrib><creatorcontrib>Demartines, Nicolas</creatorcontrib><creatorcontrib>Malagó, Massimo</creatorcontrib><creatorcontrib>Kokudo, Norihiro</creatorcontrib><creatorcontrib>Halkic, Nermin</creatorcontrib><title>Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.</description><subject>Aged</subject><subject>Albumin</subject><subject>Ascites</subject><subject>Biology and Life Sciences</subject><subject>Carcinoma, Hepatocellular - diagnosis</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - physiopathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Complications and side effects</subject><subject>Decision making</subject><subject>Evaluation</subject><subject>Female</subject><subject>Grading</subject><subject>Hepatectomy</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Indocyanine Green - pharmacokinetics</subject><subject>Liver</subject><subject>Liver - metabolism</subject><subject>Liver - physiopathology</subject><subject>Liver - surgery</subject><subject>Liver cancer</subject><subject>Liver diseases</subject><subject>Liver failure</subject><subject>Liver Function Tests</subject><subject>Liver Neoplasms - diagnosis</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - physiopathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Management</subject><subject>Mathematical models</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Grading</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>People and Places</subject><subject>Postoperative complications</subject><subject>Predictions</subject><subject>Preoperative care</subject><subject>Preoperative Period</subject><subject>Prevention</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Quality</subject><subject>Risk factors</subject><subject>Serum albumin</subject><subject>Serum Albumin - metabolism</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Systematic review</subject><subject>Thrombosis</subject><subject>Treatment Failure</subject><subject>Veins & arteries</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99q2zAUxs3YWLtubzA2wWC0F8kk64_lm0EIaRsItGzdbsWxLCcKtpRJdre-wx56SpuWZvSiGGSh8zufpO_oZNl7gseEFuTL2g_BQTveeGfGmPCSU_wiOyQlzUcix_Tlo_lB9ibGNcacSiFeZwd5wSjDIj_M_k5iNDF2xvXIN-gyGL8xAXp7bdAiDQGdDk731jtkHbpMgURG9Nv2K3RuNtB7bdp2aCGgKQRtne8AjdDVyqBJWw2ddaO5q72-AWedQWfBGIdm19AOcCt6PFnMp7OTFIDavM1eNdBG8273P8p-nM6upuejxcXZfDpZjHSR834EVIMWjFGq66I2NZQlqXlV0LLGGCinOq8lo5wYDJUspCx0JRqRyIpiSRk9yj7e6W5aH9XOyKiIxJxJnkueiPkdUXtYq02wHYQb5cGq2wUflgpCb3VrVLXNEqxqCGaMyKYUDBOhm7zkdcGpSVpfd7sNVWdqnQwM0O6J7kecXamlv1as5CSVOgkc7wSC_zWY2KvOxq3t4Iwfbs8tBWUi3e0ZqMCFJEwk9NN_6NNG7KglpLta1_h0RL0VVRPGZcEKzstEjZ-g0lebzur0QBub1vcSTvYSEtObP_0ShhjV_Pu357MXP_fZz4_YlYG2X0XfDtu3FvdBdgfq4GMMpnmoB8Fq21_3bqhtf6ldf6W0D49r-ZB031D0H19UH34</recordid><startdate>20160719</startdate><enddate>20160719</enddate><creator>Kokudo, Takashi</creator><creator>Hasegawa, Kiyoshi</creator><creator>Amikura, Katsumi</creator><creator>Uldry, Emilie</creator><creator>Shirata, Chikara</creator><creator>Yamaguchi, Takamune</creator><creator>Arita, Junichi</creator><creator>Kaneko, Junichi</creator><creator>Akamatsu, Nobuhisa</creator><creator>Sakamoto, Yoshihiro</creator><creator>Takahashi, Amane</creator><creator>Sakamoto, Hirohiko</creator><creator>Makuuchi, Masatoshi</creator><creator>Matsuyama, Yutaka</creator><creator>Demartines, Nicolas</creator><creator>Malagó, Massimo</creator><creator>Kokudo, Norihiro</creator><creator>Halkic, Nermin</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160719</creationdate><title>Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade</title><author>Kokudo, Takashi ; Hasegawa, Kiyoshi ; Amikura, Katsumi ; Uldry, Emilie ; Shirata, Chikara ; Yamaguchi, Takamune ; Arita, Junichi ; Kaneko, Junichi ; Akamatsu, Nobuhisa ; Sakamoto, Yoshihiro ; Takahashi, Amane ; Sakamoto, Hirohiko ; Makuuchi, Masatoshi ; Matsuyama, Yutaka ; Demartines, Nicolas ; Malagó, Massimo ; Kokudo, Norihiro ; Halkic, Nermin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-a3cac64433cd7deda991d5b739d00a353c2d84351e0ab87887cb6f6dedb308343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Albumin</topic><topic>Ascites</topic><topic>Biology and Life Sciences</topic><topic>Carcinoma, Hepatocellular - diagnosis</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - physiopathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Care and treatment</topic><topic>Clinical medicine</topic><topic>Complications and side effects</topic><topic>Decision making</topic><topic>Evaluation</topic><topic>Female</topic><topic>Grading</topic><topic>Hepatectomy</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Indocyanine Green - 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metabolism</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Systematic review</topic><topic>Thrombosis</topic><topic>Treatment Failure</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kokudo, Takashi</creatorcontrib><creatorcontrib>Hasegawa, Kiyoshi</creatorcontrib><creatorcontrib>Amikura, Katsumi</creatorcontrib><creatorcontrib>Uldry, Emilie</creatorcontrib><creatorcontrib>Shirata, Chikara</creatorcontrib><creatorcontrib>Yamaguchi, Takamune</creatorcontrib><creatorcontrib>Arita, Junichi</creatorcontrib><creatorcontrib>Kaneko, Junichi</creatorcontrib><creatorcontrib>Akamatsu, Nobuhisa</creatorcontrib><creatorcontrib>Sakamoto, Yoshihiro</creatorcontrib><creatorcontrib>Takahashi, Amane</creatorcontrib><creatorcontrib>Sakamoto, Hirohiko</creatorcontrib><creatorcontrib>Makuuchi, Masatoshi</creatorcontrib><creatorcontrib>Matsuyama, Yutaka</creatorcontrib><creatorcontrib>Demartines, Nicolas</creatorcontrib><creatorcontrib>Malagó, Massimo</creatorcontrib><creatorcontrib>Kokudo, Norihiro</creatorcontrib><creatorcontrib>Halkic, Nermin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints in Context (Gale)</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kokudo, Takashi</au><au>Hasegawa, Kiyoshi</au><au>Amikura, Katsumi</au><au>Uldry, Emilie</au><au>Shirata, Chikara</au><au>Yamaguchi, Takamune</au><au>Arita, Junichi</au><au>Kaneko, Junichi</au><au>Akamatsu, Nobuhisa</au><au>Sakamoto, Yoshihiro</au><au>Takahashi, Amane</au><au>Sakamoto, Hirohiko</au><au>Makuuchi, Masatoshi</au><au>Matsuyama, Yutaka</au><au>Demartines, Nicolas</au><au>Malagó, Massimo</au><au>Kokudo, Norihiro</au><au>Halkic, Nermin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-07-19</date><risdate>2016</risdate><volume>11</volume><issue>7</issue><spage>e0159530</spage><epage>e0159530</epage><pages>e0159530-e0159530</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27434062</pmid><doi>10.1371/journal.pone.0159530</doi><tpages>e0159530</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-07, Vol.11 (7), p.e0159530-e0159530 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1805485285 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Albumin Ascites Biology and Life Sciences Carcinoma, Hepatocellular - diagnosis Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - physiopathology Carcinoma, Hepatocellular - surgery Care and treatment Clinical medicine Complications and side effects Decision making Evaluation Female Grading Hepatectomy Hepatocellular carcinoma Hepatology Hospitals Humans Hypertension Indocyanine Green - pharmacokinetics Liver Liver - metabolism Liver - physiopathology Liver - surgery Liver cancer Liver diseases Liver failure Liver Function Tests Liver Neoplasms - diagnosis Liver Neoplasms - mortality Liver Neoplasms - physiopathology Liver Neoplasms - surgery Male Management Mathematical models Medical imaging Medical prognosis Medicine Medicine and Health Sciences Middle Aged Mortality Neoplasm Grading Patient outcomes Patients People and Places Postoperative complications Predictions Preoperative care Preoperative Period Prevention Prognosis Prospective Studies Quality Risk factors Serum albumin Serum Albumin - metabolism Surgery Surgical outcomes Survival Survival Analysis Systematic review Thrombosis Treatment Failure Veins & arteries |
| title | Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma - The Albumin-Indocyanine Green Evaluation (ALICE) Grade |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T09%3A05%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Assessment%20of%20Preoperative%20Liver%20Function%20in%20Patients%20with%20Hepatocellular%20Carcinoma%20-%20The%20Albumin-Indocyanine%20Green%20Evaluation%20(ALICE)%20Grade&rft.jtitle=PloS%20one&rft.au=Kokudo,%20Takashi&rft.date=2016-07-19&rft.volume=11&rft.issue=7&rft.spage=e0159530&rft.epage=e0159530&rft.pages=e0159530-e0159530&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0159530&rft_dat=%3Cgale_plos_%3EA458747559%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1805485285&rft_id=info:pmid/27434062&rft_galeid=A458747559&rft_doaj_id=oai_doaj_org_article_b805464bf104418f964016cf295d753e&rfr_iscdi=true |