![]() ![]() ![]() MELD score was calculated using pre-operative values of three laboratory tests: INR for prothrombin time, serum total bilirubin (TBil) and serum creatinine (Cr). Fifty nine patients were classified as CPT class A(89.8%) and one patient as CPT class B, score 7 (10.2%). CPT class was calculated using prothrombin time, albumin, bilirubin and clinical findings of ascitis and encephalopathy. Clinical and pathological features of the patients are reported in ( Tables 1 & 2). We identified 60patients fulfilling the above criteria. HCC was pathologically confirmed in all patients included in the study. We retrospectively analyzed the clinical records of all patients with HCC, who underwent hepatic resection in our institution between January 2007and June 2010. An effort to subcategorize the low-from the high-risk class A patients is provided. 14, 15 The aim of this study was to examine whether the pre-operative MELD score can predict post-operative mortality, morbidity, hospital stay and 3-year survival in cirrhotic class A patients undergoing hepatectomy for HCC. 12 It has also been used to determine priority on waiting lists for liver transplantation 13 and in predicting post-operative outcome of cirrhotic patients, undergoing surgical procedures. MELD score is used for survival prediction in cirrhotic patients receiving a transjugular intrahepatic portosystemic shunt. 12–15 It has the advantage of using three objective and easily measured parameters: creatinine levels, international normalized ratio (INR) and total bilirubin. 8–11 The model for end-stage liver disease (MELD) score was recently introduced to evaluate hepatic function reserve in cirrhotic patients. More refined evaluation of the liver function reserve is often needed, as a result of limitations in the discriminatory ability of the CPT system, as it uses subjective parameters, such as ascites and encephalopathy. 5–7 CPT class A patients are generally considered good candidates for hepatic resection and good post-operative outcome is expected. 5 CPT class C is considered an absolute contraindication for surgical treatment, whereas only few hepatectomies are performed in class B cirrhosis. 3, 4 Therefore, a thorough evaluation of the hepatic function reserve is necessary prior to surgical intervention, in order to select the best candidates for hepatic resection among cirrhotic patients, with reasonable post-operative morbidity and mortality.Ĭhild-Pugh-Turcotte (CPT) classification was the first systematic approach used to determine the severity of cirrhosis and select those patients who could tolerate hepatic resection. The risk of hepatic failure in a cirrhotic patient undergoing hepatectomy still remains high, as a result of compromised function of the liver remnant. 2 Evolution in surgical techniques and peri-operative care have improved post-operative outcome, in patients with severe under-lying liver disease undergoing hepatectomy. 1 The mainstay of treatment, in patients with solitary HCC and good liver function, is hepatic resection. Its incidence is 1:500000 and it is strongly correlated with cirrhosis. Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Keywords : hepatocellular carcinoma, meld score, hepatectomy, cirrhosis,liver resection outcome Abbreviations Three-year survival reached 51% (66% when MELD≤9 29% when MELD>9 (P<0.01).Ĭonclusion: MELD score seems to predict outcome of cirrhotic patients with HCC, after hepatectomy. MELD≤9 was associated with 2.6% peri-operative mortality vs. Results: Eleven major and 49 minor resections were performed. MELD score was associated with post-operative mortality and morbidity, hospital stay and 3-year survival. Methods: between the periods from January 2007to June 2010in National liver Institute (NLI) - Menoufiya University 60 cirrhotic patients with HCC underwent hepatectomy and the results were retrospectively analysed. Background/Aims: To evaluate the ability of the model for end-stage liver disease (MELD) in predicting the post-hepatectomy outcome for hepatocellular carcinoma (HCC). ![]()
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