A Novel Predictive Scoring System for 90-Day Mortality among Patients with Hepatocellular Cell Carcinoma Receiving Major Hepatectomy

Ruey-Shyang Soong; Yi-Chan Chen; Ta-Chun Chou; Po-Hsing Chiang; Wan-Ming Chen; Ming-Feng Chiang; Ben-Chang Shia; Szu-Yuan Wu

doi:10.3390/cancers14061398

A Novel Predictive Scoring System for 90-Day Mortality among Patients with Hepatocellular Cell Carcinoma Receiving Major Hepatectomy

Cancers (Basel). 2022 Mar 9;14(6):1398. doi: 10.3390/cancers14061398.

Authors

Ruey-Shyang Soong^{1

2

3}, Yi-Chan Chen¹, Ta-Chun Chou¹, Po-Hsing Chiang¹, Wan-Ming Chen⁴, Ming-Feng Chiang⁵, Ben-Chang Shia^{4

6}, Szu-Yuan Wu^{4

6

7

8

9

10

11}

Affiliations

¹ Department of General Surgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan.
² Division of General Surgery, Chang Gung Medical College Taoyuan, Taoyuan 333, Taiwan.
³ Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung 204, Taiwan.
⁴ Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City 242, Taiwan.
⁵ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁶ Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242, Taiwan.
⁷ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
⁸ Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁹ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
¹⁰ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
¹¹ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.

Abstract

Purpose: Hepatocellular carcinoma (HCC) is a major malignancy and the common cause of cancer-related deaths. Surgical intervention provides superior long-term survival outcomes; however, perioperative mortality is a major concern for clinicians while making treatment decisions, especially for major hepatectomy. Scoring systems for predicting 90-day mortality in patients with HCC undergoing major hepatectomy are not available.

Methods: This study used the Taiwan Cancer Registry Database that is linked to the National Health Insurance Research Database to analyze data of 60,250 patients with HCC who underwent major hepatectomy and determine risk factors to establish a novel predictive scoring system. By using the stepwise selection of the multivariate Cox proportional hazards model, we divided the patients with HCC undergoing major hepatectomy into four risk groups.

Results: The Chang Gung-PohAi predictive scoring system exhibited significant differences in the 90-day mortality rate among the four risk groups (very low risk: 2.42%, low risk: 4.09%, intermittent risk: 17.1%, and high risk: 43.6%).

Conclusion: The Chang Gung-PohAi predictive scoring system is a promising tool for predicting 90-day perioperative mortality in patients with HCC undergoing major hepatectomy.

Keywords: 90-day mortality; hepatectomy; hepatocellular carcinoma; overall survival; predictive scoring.