The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy
Abstract Post hepatectomy liver failure (PHLF) poses a significant threat to the prognosis of patients with hepatocellular carcinoma (HCC), particularly those undergoing major hepatectomy. The present research endeavors to clarify the influence of prealbumin on the development of PHLF in HCC patient...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-12400-0 |
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| author | Hang-Dong Jia Zhe-Jin Shi Jian-Yong Yuan Kai Wang Yang Yu Zheng-Kang Fang Kai-Di Wang Yi Lu Guo-Liang Shen Cheng-Wu Zhang Lei Liang |
| author_facet | Hang-Dong Jia Zhe-Jin Shi Jian-Yong Yuan Kai Wang Yang Yu Zheng-Kang Fang Kai-Di Wang Yi Lu Guo-Liang Shen Cheng-Wu Zhang Lei Liang |
| author_sort | Hang-Dong Jia |
| collection | DOAJ |
| description | Abstract Post hepatectomy liver failure (PHLF) poses a significant threat to the prognosis of patients with hepatocellular carcinoma (HCC), particularly those undergoing major hepatectomy. The present research endeavors to clarify the influence of prealbumin on the development of PHLF in HCC patients who have undergone major hepatectomy. Patients with HCC who have undergone major hepatectomy were included. Based on the ROC curve, the optimal cut-off value for prealbumin was determined and patients were divided into two groups. Univariate and multivariate logistic analyses were conducted to identify risk factors for PHLF in HCC patients. Furthermore, the predictive ability of PHLF was also evaluated. 466 patients were included, among whom 98 (21%) developed PHLF. Compared with the high prealbumin group, patients in the low prealbumin group had significantly higher proportions of cirrhosis, portal hypertension, intraoperative blood loss, and transfusion, as well as a higher incidence of PHLF (12.3% vs. 23.5%, P = 0.011). Multivariate analysis revealed that prealbumin is a risk factor for PHLF (HR 1.446, 95%CI 1.091–2.369, P = 0.015), but it is not a risk factor for severe PHLF (HR 1.183, 95%CI 0.584–2.692, P = 0.289). However, the comprehensive indicator, prealbumin-bilirubin (preALBI), is not only a risk factor for PHLF but also severe PHLF. Furthermore, its predictive performance is significantly higher than that of other related indicators (all P < 0.05). Patients with low prealbumin levels require perioperative protocols: precise resection control, liver volume assessment, and PHLF prevention monitoring. |
| format | Article |
| id | doaj-art-2968c1a2e8cf411bacb7b68fe732a639 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-2968c1a2e8cf411bacb7b68fe732a6392025-08-20T03:04:38ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-12400-0The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomyHang-Dong Jia0Zhe-Jin Shi1Jian-Yong Yuan2Kai Wang3Yang Yu4Zheng-Kang Fang5Kai-Di Wang6Yi Lu7Guo-Liang Shen8Cheng-Wu Zhang9Lei Liang10General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeHepatobiliary Pancreatic Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeDepartment of Urology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeAbstract Post hepatectomy liver failure (PHLF) poses a significant threat to the prognosis of patients with hepatocellular carcinoma (HCC), particularly those undergoing major hepatectomy. The present research endeavors to clarify the influence of prealbumin on the development of PHLF in HCC patients who have undergone major hepatectomy. Patients with HCC who have undergone major hepatectomy were included. Based on the ROC curve, the optimal cut-off value for prealbumin was determined and patients were divided into two groups. Univariate and multivariate logistic analyses were conducted to identify risk factors for PHLF in HCC patients. Furthermore, the predictive ability of PHLF was also evaluated. 466 patients were included, among whom 98 (21%) developed PHLF. Compared with the high prealbumin group, patients in the low prealbumin group had significantly higher proportions of cirrhosis, portal hypertension, intraoperative blood loss, and transfusion, as well as a higher incidence of PHLF (12.3% vs. 23.5%, P = 0.011). Multivariate analysis revealed that prealbumin is a risk factor for PHLF (HR 1.446, 95%CI 1.091–2.369, P = 0.015), but it is not a risk factor for severe PHLF (HR 1.183, 95%CI 0.584–2.692, P = 0.289). However, the comprehensive indicator, prealbumin-bilirubin (preALBI), is not only a risk factor for PHLF but also severe PHLF. Furthermore, its predictive performance is significantly higher than that of other related indicators (all P < 0.05). Patients with low prealbumin levels require perioperative protocols: precise resection control, liver volume assessment, and PHLF prevention monitoring.https://doi.org/10.1038/s41598-025-12400-0Hepatocellular carcinomaMajor hepatectomyPost hepatectomy liver failurePrealbuminPrealbumin-bilirubin |
| spellingShingle | Hang-Dong Jia Zhe-Jin Shi Jian-Yong Yuan Kai Wang Yang Yu Zheng-Kang Fang Kai-Di Wang Yi Lu Guo-Liang Shen Cheng-Wu Zhang Lei Liang The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy Scientific Reports Hepatocellular carcinoma Major hepatectomy Post hepatectomy liver failure Prealbumin Prealbumin-bilirubin |
| title | The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy |
| title_full | The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy |
| title_fullStr | The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy |
| title_full_unstemmed | The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy |
| title_short | The value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy |
| title_sort | value of prealbumin in predicting post hepatectomy liver failure for patients with hepatocellular carcinoma undergoing major hepatectomy |
| topic | Hepatocellular carcinoma Major hepatectomy Post hepatectomy liver failure Prealbumin Prealbumin-bilirubin |
| url | https://doi.org/10.1038/s41598-025-12400-0 |
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