TY - JOUR
T1 - A Nomogram to Predict Hypertrophy of Liver Segments 2 and 3 After Right Portal Vein Embolization
AU - Mise, Yoshihiro
AU - Passot, Guillaume
AU - Wang, Xuemei
AU - Chen, Hsiang Chun
AU - Wei, Steven
AU - Brudvik, Kristoffer W.
AU - Aloia, Thomas A.
AU - Conrad, Claudius
AU - Huang, Steven Y.
AU - Vauthey, Jean Nicolas
N1 - Publisher Copyright:
© 2016, The Society for Surgery of the Alimentary Tract.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background: Portal vein embolization (PVE) reduces the risks of hepatic insufficiency after major hepatectomy for small predicted liver remnant. The extent of liver hypertrophy after PVE depends on various clinical factors. We sought to develop a nomogram for predicting the increase in the volume of segments 2 and 3 after right PVE (RPVE). Method: In 360 patients who underwent RPVE from 1998 through 2013, clinicopathologic data were analyzed, including body mass index (BMI), diabetes, aspirin use, viral hepatitis status, preoperative albumin level, total bilirubin level, prothrombin time, platelet count, type of liver neoplasm, preoperative chemotherapy, previous laparotomy or hepatectomy, segment 4 embolization, two-stage hepatectomy, and liver volumes before and after PVE. Multivariate linear regression analysis was used to identify variables predicting the degree of hypertrophy of segments 2 and 3. Results: Multivariate regression analysis revealed that BMI (p = 0.002), previous hepatectomy (p = 0.03), RPVE in the setting of two-stage hepatectomy (p < 0.001), and segment 4 embolization (p = 0.003) independently predicted the degree of hypertrophy of segments 2 and 3. Based on the fitted model, a nomogram was constructed. Conclusion: The constructed nomogram predicts the degree of hypertrophy of segments 2 and 3 after RPVE and can be used in clinical decision making for patients undergoing right hepatectomy.
AB - Background: Portal vein embolization (PVE) reduces the risks of hepatic insufficiency after major hepatectomy for small predicted liver remnant. The extent of liver hypertrophy after PVE depends on various clinical factors. We sought to develop a nomogram for predicting the increase in the volume of segments 2 and 3 after right PVE (RPVE). Method: In 360 patients who underwent RPVE from 1998 through 2013, clinicopathologic data were analyzed, including body mass index (BMI), diabetes, aspirin use, viral hepatitis status, preoperative albumin level, total bilirubin level, prothrombin time, platelet count, type of liver neoplasm, preoperative chemotherapy, previous laparotomy or hepatectomy, segment 4 embolization, two-stage hepatectomy, and liver volumes before and after PVE. Multivariate linear regression analysis was used to identify variables predicting the degree of hypertrophy of segments 2 and 3. Results: Multivariate regression analysis revealed that BMI (p = 0.002), previous hepatectomy (p = 0.03), RPVE in the setting of two-stage hepatectomy (p < 0.001), and segment 4 embolization (p = 0.003) independently predicted the degree of hypertrophy of segments 2 and 3. Based on the fitted model, a nomogram was constructed. Conclusion: The constructed nomogram predicts the degree of hypertrophy of segments 2 and 3 after RPVE and can be used in clinical decision making for patients undergoing right hepatectomy.
KW - Cholangiocarcinoma
KW - Embolization
KW - Liver neoplasms
KW - Liver regeneration
KW - Therapeutic
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U2 - 10.1007/s11605-016-3145-8
DO - 10.1007/s11605-016-3145-8
M3 - Article
C2 - 27073080
AN - SCOPUS:84963684558
SN - 1091-255X
VL - 20
SP - 1317
EP - 1323
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 7
ER -