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Hepatology · Surgery

Liver decompensation risk after hepatectomy for hepatocellular carcinoma calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Extent of resection

Major or minor is the class assigned by the operating team. The report does not print a segment count, so none is invented here.

points

Allowed range: 6–40 points

Quick picks

Enter the pre-sodium MELD integer already calculated for the admission. A value of 9 stays in the low class only when portal hypertension is absent and the resection is minor. A value of 10 does not.

Result

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Clinical inputs

  • Portal hypertension
  • Extent of resection
  • MELD pointsAccepted range: 6 to 40

Primary source

Citterio D et al. Hierarchic interaction of factors associated with liver decompensation after resection for hepatocellular carcinoma. JAMA Surg. 2016;151(9):846-853. DOI: 10.1001/jamasurg.2016.1121. PMID: 27248425. High risk is portal hypertension together with major hepatectomy: liver decompensation 60.0% (12/20) and liver-related mortality 25.0% (5/20). Low risk is no portal hypertension, minor resection, and MELD of 9 or lower: liver decompensation 4.9% (11/226) and liver-related mortality 4.4% (10/226). Every other pairing is intermediate: liver decompensation 28.6% (85/297) and liver-related mortality 9.0% (27/297). Median length of stay was 7, 8, and 11 days for low, intermediate, and high. Ten-fold cross-validation C index was 0.78. This score uses the class the paper reports. It does not recalculate MELD and it does not assign a Couinaud segment count, because the opened report does not print one. (2016)

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