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Platelet-albumin (PAL) score as a predictor of perioperative outcomes and survival in patients with hepatocellular carcinoma undergoing liver resection in a Western center

2022; Elsevier BV; Volume: 42; Linguagem: Inglês

10.1016/j.suronc.2022.101752

1879-3320

José Donizeti de Meira Júnior, Gilton Marques Fonseca, Francisco Nolasco de Carvalho Neto, Vagner Birk Jeismann, Jaime Arthur Pirola Krüger, João Paulo Maciel Silva, Fabrício Ferreira Coelho, Paulo Herman,

Liver Disease Diagnosis and Treatment

Preoperative selection of patients with hepatocellular carcinoma (HCC) who will benefit from resection is highly advisable. The Platelet-Albumin (PAL) score was developed as a predictor of survival and morbidity following HCC resection. However, this has never been tested in western populations.The impact of PAL score on perioperative outcomes and survival was evaluated and compared to Child-Pugh, Model for End-Stage Liver Disease (MELD), and albumin-bilirubin (ALBI) scores in patients who underwent HCC resection.A total of 182 patients were included. Postoperative morbidity was higher in patients with PAL grade II-III (P = 0.039), ALBI grade II-III (P = 0.028), and MELD >10 (P = 0.042). Post-hepatectomy liver failure (PHLF) occurred in 36 patients (19.8%) and was significantly higher in the PAL II-III and ALBI score II-III subgroup (P = 0.001). The PAL II-III group was the only one associated with higher perioperative mortality (OR 3.3, P = 0.036). The PAL score was an independent prognostic factor for overall survival in multivariate analysis (P = 0.018) and was the only one with the areas under the curve in ROC analysis significantly different for morbidity, PHLF, and mortality.The PAL score predicts postoperative complications, mortality, PHLF, and survival following liver resection for HCC in western patients.