title: A new prediction model of postoperative complications after major hepatectomy for hepatocellular carcinoma.
abstract: OBJECTIVE
  Serum hyaluronic acid (HA) concentrations reflect the degree of hepatic dysfunction and may have potential for predicting postoperative complications in a major hepatectomy for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Serum HA concentrations and other conventional liver function tests were measured prior to major hepatectomies in 52 patients. Independent predictors for postoperative complications were analyzed and the discriminant equation was established and validated.
  
  
  RESULTS
  Postoperative complications occurred in 17 patients. Serum HA concentrations and the estimated remnant liver volume ratio (remnant Vol%) were recognized as independent predictors for postoperative complications (OR 1.03, 0.85; CI 95% 1.01-1.06, 0.76-0.95; p = 0.006, 0.006; respectively) and produced the discriminant equation: logit = 4.15 + 0.03 x (HA) -0.16 x (remnant Vol%). The value of the area under the curve of a receiver operating characteristic analysis was 0.92. If the cut-off of the logit value was set to 0, then the predictive accuracy was 0.88. The validation accuracy performed by a leave-one-out cross-validation method was 0.83.
  
  
  CONCLUSIONS
  The constructed discriminant equation model consisting of the preoperative serum HA concentrations and estimated remnant Vol% could be useful for predicting postoperative complications in a major hepatectomy for HCC.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Satoru
authors.initials: S
authors.lastname: Ozawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Hayami
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000601:surgery; D016002:Discriminant Analysis; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D006820:Hyaluronic Acid