title: The FIB-4 score predicts postoperative short-term outcomes of hepatocellular carcinoma fulfilling the milan criteria.
abstract: BACKGROUND
  The fibrosis score 4 (FIB-4) score is a useful tool to determine the degree of hepatic fibrosis. Liver fibrosis and cirrhosis are well-known predictors of postoperative complications after hepatectomy. This study examined the impact of FIB-4 on postoperative short-term outcomes of patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Three hundred and fifty patients undergoing hepatectomy for HCC between 2008 and 2013 were enrolled. The receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of the FIB-4. Univariate and multivariate analysis was performed to identify the risk factors. The correlation of the preoperative FIB-4 value with clinicopathological parameters was examined.
  
  
  RESULTS
  Postoperative complications were observed in 202 (57.7%) patients. The optimal cutoff value of the FIB-4 was set at 2.88 and 3.85 for postoperative complications and intraoperative blood loss respectively. It was also an independent prognostic factor for postoperative complications (hazard ratio [HR], 1.202; 95% CI, 1.076-1.344; P = 0.001) and intraoperative blood loss (HR, 1.196; 95% CI, 1.091-1.343; P < 0.001) by multivariate analysis. The FIB-4 was significantly correlated with age, liver function, coagulation function, blood loss, intraoperative blood transfusion (all P < 0.05).
  
  
  CONCLUSIONS
  Preoperative FIB-4 is a useful index to predict postoperative outcomes in patients with HCC. The FIB-4 should be assessed routinely for hepatocellular carcinoma patients.
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: J
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: X-h
authors.initials: XH
authors.lastname: Xu
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: M-y
authors.initials: MY
authors.lastname: Ke
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: J-x
authors.initials: JX
authors.lastname: Xiang
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: W-y
authors.initials: WY
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: X-m
authors.initials: XM
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: B
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
authors.forename: X-f
authors.initials: XF
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China. Electronic address: Luyi169@126.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Lv
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D002648:Child; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: FIB-4; Hepatectomy; Hepatocellular carcinoma; Short-term outcomes