Peri-operative score for elderly patients with resectable hepatocellular carcinoma

Table 1 Characteristics of samples used to study the variables and deaths 180 d after surgery, n (%)

	All		Alive at 180 d		Death at 180 d		HR	P value
	N	n = 429	N	n = 409	N	n = 20
Age, yr	429	75.3 ± 4.1	409	75.3 ± 4.1	20	76.9 ± 4.9	1.52 (0.94-2.47)	0.086
Male	429	319 (74.4)	409	306 (74.8)	20	13 (65.0)	0.61 (0.24-1.54)	0.296
BMI	429	26.9 ± 3.5	409	26.9 ± 3.6	20	26.9 ± 0.9	0.97 (0.52-1.82)	0.921
ASA score	429	2.60 ± 0.50	409	2.59 ± 0.50	20	2.90 ± 0.31	4.49 (1.47-13.74)	0.008
Comorbidity > 2	429	142 (33.1)	409	129 (31.5)	20	13 (65.0)	3.92 (1.56-9.82)	0.004
HBV	429	80 (18.6)	409	80 (19.6)	20	0 (0.0)	-	-
HCV	429	217 (50.6)	409	210 (51.3)	20	7 (35.0)	0.51 (0.2-1.28)	0.151
ALD	429	60 (14.0)	409	56 (13.7)	20	4 (20.0)	1.58 (0.53-4.72)	0.415
Others	429	72 (16.8)	409	63 (15.4)	20	9 (45.0)	4.3 (1.78-10.37)	0.001
F4 cirrhosis	429	178 (41.5)	409	173 (42.3)	20	5 (25.0)	0.46 (0.17-1.27)	0.134
CHILD A	429	370 (86.2)	409	353 (86.3)	20	17 (85.0)	0.92 (0.27-3.13)	0.891
MELD score	429	7.4 ± 2.1	409	7.4 ± 2.0	20	8.9 ± 2.7	1.25 (1.09-1.44)	0.001
Albumin	382	3.80 ± 0.60	367	3.80 ± 0.60	15	3.71 ± 0.77	0.75 (0.33-1.73)	0.504
Bilirubin	424	1.05 ± 0.64	404	1.05 ± 0.64	20	0.99 ± 0.54	0.81 (0.37-1.76)	0.587
Creatinin	425	1.03 ± 0.36	405	1.02 ± 0.36	20	1.17 ± 0.42	2.55 (0.9-7.2)	0.077
INR	422	1.20 ± 0.23	402	1.20 ± 0.23	20	1.17 ± 0.28	0.51 (0.07-3.8)	0.508
AST	424	68 ± 61	405	69 ± 61	19	48 ± 41	0.92 (0.85-1)	0.045
ALT	201	51 ± 80	182	52 ± 82	19	41 ± 48	0.98 (0.91-1.05)	0.540
GGT	192	145 ± 218	174	145 ± 218	18	146 ± 228	1 (0.98-1.02)	0.958
Platelets	425	191 ± 92	406	191 ± 92	19	177 ± 85	0.98 (0.93-1.04)	0.509
Number of lesions	429	1.09 ± 0.30	409	1.09 ± 0.31	20	1.05 ± 0.22	0.54 (0.08-3.77)	0.531
Size of biggest lesion (mm)	429	33 ± 10	409	32 ± 10	20	37 ± 13	1.26 (1.01-1.58)	0.043
Bilobar lesion	429	8 (1.9)	409	8 (2.0)	20	0 (0.0)	-	-
Preop treatment	429	53 (12.4)	409	50 (12.2)	20	3 (15.0)	1.24 (0.36-4.23)	0.732
Major HTC	429	56 (13.1)	409	55 (13.4)	20	1 (5.0)	0.34 (0.05-2.56)	0.297

BMI: Body mass index; ASA: American Society of Anesthesiology; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; Major HTC: Hepatectomy; ALD: Alcoholic liver disease; HBV: Hepatitis B virus; HCV: Hepatitis C virus; MELD: Mayo end liver disease score; INR: International normalized ratio; HR: Hazard ratio.

Table 2 Multivariate analysis

	Beta	HR	P value
ASA score	1.189	3.28 (1.04-10.34)	0.042
Comorbidity 2	1.071	2.92 (1.14-7.45)	0.025
MELD	0.202	1.22 (1.06-1.41)	0.005
Size of largest lesion	0.046	1.05 (1.01-1.09)	0.034
C-index = 0.807	-	-	-

ASA: American Society of Anesthesiology; MELD: Mayo end liver disease; HR: Hazard ratio.

Table 3 Score point system

	Values	Points
ASA score	1	0
	2	0
	3	2
	4	3
Comorbidity > 2	Yes	1
MELD	< 8	0
	8-12	1
	> 12	2
Size of largest lesion (mm)	≤ 10	0
	10-32	1
	> 32	2
	Max score	8

ASA: American Society of Anesthesiology; MELD: Mayo end liver disease.

Table 4 Stratification of mortality risk on preoperative score

Score	Number and prevalence, n (%)	Three-month mortality, %	Six-month mortality, %
≥ 2 vs ≤ 1	366 (85.3) vs 63 (14.7)	3.3 vs 0.0	5.7 vs 0.0
≥ 3 vs ≤ 2	296 (69.0) vs 133 (31.0)	4.1 vs 0.0	7.0 vs 0.0
≥ 4 vs ≤ 3	213 (49.7) vs 216 (50.3)	5.3 vs 0.5	9.3 vs 0.5
≥ 5 vs ≤ 4	102 (23.8) vs 327 (76.2)	5.0 vs 2.2	13.6 vs 2.2
≥ 6 vs ≤ 5	28 (6.5) vs 401 (93.5)	11.3 vs 2.3	22.9 vs 3.6