ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1670396
This article is part of the Research TopicDigital Technologies in Hepatology: Diagnosis, Treatment, and Epidemiological InsightsView all 15 articles
Establishing a Nomogram for Post-Hepatectomy Liver Failure Prediction in Hepatocellular Carcinoma Based on Preoperative and Perioperative Parameters
Provisionally accepted
- 1Department of Outpatient, Gansu Provincial Hospital, Lanzhou, China
- 2Department of Clinical Laboratory, Gansu Provincial Hospital,, lanzhou, China
- 3Department of Clinical Laboratory, Gansu Provincial Hospital, Lanzhou, China
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OBJECTIVE: Post-hepatectomy liver failure (PHLF) is a severe complication for hepatocellular carcinoma (HCC) patients post-surgery. This study explores PHLF risk factors and creates a nomogram for prediction using pre-and intraoperative factors. METHODS: We retrospectively analyzed 654 patients who underwent hepatectomy. Eligible patients were randomly divided into training and internal validation cohorts in a 7:3 ratio. Key variables for nomogram construction were determined through integrated LASSO and multivariate logistic regression analyses. The nomogram's performance was evaluated using ROC curves, calibration curves, and decision curve analysis. RESULTS: Among 228 eligible patients included in the study, 55 developed PHLF. Seven independent predictors were identified and incorporated into the nomogram: liver cirrhosis, total bilirubin (TBIL), prothrombin time (PT), ALBI, FIB4, ascites, and intraoperative blood loss. The nomogram demonstrated excellent predictive performance, with AUC of 0.880 in the training cohort and 0.879 in the validation cohort. Calibration curve and decision curve analysis show that nomogram has significant clinical application value in predicting PHLF probability. CONCLUSION: We have developed and validated a novel PHLF risk prediction model that integrates preoperative and intraoperative parameters, along with various liver function scoring systems, enabling more comprehensive and accurate prediction of PHLF risk in HCC patients.
Keywords: hepatocellular carcinoma (HCC), Post-hepatectomy liver failure (PHLF), nomogram, Preoperative, Perioperative
Received: 21 Jul 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Zhang, Wang, Ma, Zhang, Hou, Zhang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingheng Zhang, Department of Outpatient, Gansu Provincial Hospital, Lanzhou, China
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