title: Model for end-stage liver disease (MELD) score, as a prognostic factor for post-operative morbidity and mortality in cirrhotic patients, undergoing hepatectomy for hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the ability of the model for end-stage liver disease (MELD) in predicting the post-hepatectomy outcome for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between 2001 and 2004, 69 cirrhotic patients with HCC underwent hepatectomy and the results were retrospectively analysed. MELD score was associated with post-operative mortality and morbidity, hospital stay and 3-year survival.
  
  
  RESULTS
  Seventeen major and 52 minor resections were performed. Thirty-day mortality rate was 7.2%. MELD < or = 9 was associated with no peri-operative mortality vs. 19% when MELD > 9 (P < 0.02). Overall morbidity rate was 36.23%; 48% when MELD > 9 vs. 25% when MELD < or = 9 (P < 0.02). Median hospital stay was 12 days [8.8 days, when MELD < or = 9 and 15.6 days when MELD > 9 (P = 0.037)]. Three-year survival reached 49% (66% when MELD < or = 9; 32% when MELD > 9 (P < 0.01). In multivariate analysis, MELD > 9 (P < 0.01), clinical tumour symptoms (P < 0.05) and American Society of Anesthesiologists (ASA) score (P < 0.05) were independent predictors of peri-operative mortality; MELD > 9 (P < 0.01), tumour size >5 cm (P < 0.01), high tumour grade (P = 0.01) and absence of tumour capsule (P < 0.01) were independent predictors of decreased long-term survival.
  
  
  CONCLUSIONS
  MELD score seems to predict outcome of cirrhotic patients with HCC, after hepatectomy.
authors.affiliation: Division of Liver and GI Transplantation, University of Miami Miller School of Medicine, Miami, FL, USA. sgdelis55@yahoo.gr
authors.forename: Spiros G
authors.initials: SG
authors.lastname: Delis
authors.forename: Andreas
authors.initials: A
authors.lastname: Bakoyiannis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Biliatis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Athanassiou
authors.forename: Nikos
authors.initials: N
authors.lastname: Tassopoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Dervenis