Good performance of liver stiffness measurement in the prediction of postoperative hepatic decompensation in patients with cirrhosis complicated with hepatocellular carcinoma

Procopeţ, Bogdan; Fischer, Petra; Horhat, Adelina; Moiş, Emil; Ştefănescu, Horia; Comsa, Mihai; Graur, Florin; Bartoș, Adrian; Lupșor-Platon, Monica; Badea, Radu; Grigorescu, Mircea; Tanţău, Marcel; Spârchez, Zeno; Hajjar, Nadim Al

doi:10.11152/mu-1548

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…Finally, LSM by VCTE predicts not only the presence of CSPH but also CSPH-related complications such as hepatic decompensation in patients with compensated cirrhosis due to chronic hepatitis C (CHC), 31 in (mostly) cirrhotic patients of diverse etiologies, 32,33 as well as in patients undergoing hepatectomy, [34][35][36] with similar accuracy, as compared with HVPG. However, all of these studies were rather small, limiting the statistical power to detect clinically meaningful differences in the prognostic value of LSM by VCTE and HVPG.…”

Section: Liver Stiffness Measurement By Vibration-controlled Transienmentioning

confidence: 99%

“…104 Llop et al 100 confirmed the applicability of previously established highly sensitive (13.6 kPa 25 ) and highly specific (21 kPa 28 ) LSM by VCTE cut-offs for ruling-in and ruling-out CSPH in patients with HCC. Besides diagnosing CSPH, several noninvasive methods (e.g., LSM [34][35][36]45,46 and SSM, 54,55 ICG clearance, 75 and VWF 96 ) have been shown to directly predict adverse outcomes (i.e., liver failure, hepatic decompensation, and/or late recurrence) after hepatectomy; however, most of these studies also included non-ACLD patients, who are more easy to classify as compared with patients with compensated cirrhosis and CTP stage A.…”

Section: Ruling-in and Ruling-out/diagnosing Clinically Significant Pmentioning

confidence: 99%

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Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

et al. 2020

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Noninvasive diagnostics for portal hypertension include imaging and functional tests, as well as blood-based biomarkers, and capture different features of the portal hypertensive syndrome. Definitive conclusions regarding their clinical utility require assessment of their diagnostic value in specific clinical settings (i.e., diagnosing a particular hemodynamic condition within a well-defined target population). Several noninvasive methods are predictive of clinically significant portal hypertension (CSPH; hepatic venous pressure gradient [HVPG] ≥ 10 mm Hg; the threshold for complications of portal hypertension); however, only a minority of them have been evaluated in compensated advanced chronic liver disease (i.e., the target population). Importantly, most methods correlate only weakly with HVPG at high values (i.e., in patients with CSPH). Nevertheless, selected methods show promise for diagnosing HVPG ≥ 16 mm Hg (the cut-off for increased risks of hepatic decompensation and mortality) and monitoring HVPG changes in response to nonselective beta-blockers or etiological treatments. Finally, we review established and potential future clinical applications of noninvasive methods.

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Section: Liver Stiffness Measurement By Vibration-controlled Transienmentioning

confidence: 99%

Section: Ruling-in and Ruling-out/diagnosing Clinically Significant Pmentioning

confidence: 99%

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

et al. 2020

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“…Liver stiffness (LS) assessed by TE or shear-wave-elastography has been reported as a significant predictor of PHLF in HCC patients. [12][13][14] Magnetic resonance elastography (MRE), an magnetic resonance imaging (MRI)-based tool for the quantitative assessment of LS, is considered the most accurate non-invasive technique for assessing liver fibrosis. 15,16 Recently, MRE-assessed LS (MRE-LS) has been highlighted as a potential prognostic biomarker in HCC patients.…”

Section: Introductionmentioning

confidence: 99%

Risk Prediction Model Based on Magnetic Resonance Elastography-Assessed Liver Stiffness for Predicting Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

et al. 2022

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“…Liver stiffness measurement In the last few years, the liver stiffness measurement (LSM) has been proposed as a practical and widely validated surrogate of liver fibrosis and portal hypertension, able to accurately predict the risk of cirrhosis [79] , CSPH [80] and its complications, such as the development of varices [81] and hepatic decompensation [82] . Given that these attributes are major determinants of the risk of PHLF development, LSM has been investigated as a predictor of decompensation and other complications after hepatic resection with several methods that are mainly ultrasound-based [11,[83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99] [ Table 3].…”

Section: Ultrasound-based and Other Imaging Predictorsmentioning

confidence: 99%

Non-invasive tests for the prediction of post-hepatectomy liver failure in the elderly

Marasco¹,

Colecchia²,

Milandri³

et al. 2020

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Post-hepatectomy liver failure (PHLF) is associated with great morbidity and mortality after resection of hepatocellular carcinoma. Previous studies have underlined that advanced age could be a potential factor influencing post-operative complications and long-term survival. In the past, candidates for resection were based on the Child-Pugh classification, the predictive value of which was rather low. The selection of patients undergoing resection in Western countries is based on the assessment of portal hypertension (PH), which is clinically assessed by measurement of the hepatic venous pressure gradient, an invasive and costly process. Thus, there have been several attempts to identify the best non-invasive test (NIT) to accurately predict PHLF. Most biochemical NITs for the prediction of PHLF are focused on evaluation of underlying liver cirrhosis and PH. Amongst them, FIB-4, which also includes the patient's age, seems to have more robust supporting results. In Europe and the USA., the most tested and reliable NIT for predicting PHLF is the evaluation of liver stiffness measurement, which is also influenced by age. Imaging parameters are promising tools which are used only in specialized centers however, and when available. Liver volume parameters, as well as contrastenhanced data, demonstrate good accuracy in predicting PHLF. In this scenario, the evaluation of sarcopenia and bone mineral density through contextual imaging allows the delineation of PHLF in at-risk elderly patients. Further studies focused on parameters for the evaluation of PHLF in elderly patients are needed.

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Good performance of liver stiffness measurement in the prediction of postoperative hepatic decompensation in patients with cirrhosis complicated with hepatocellular carcinoma

Abstract: LSM has a similar performance to HVPG in predicting decompensation at 3 months in patients with early HCC submitted to liver resection. Three-month decompensation is better associated with survival.

Cited by 17 publications

References 18 publications

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

Risk Prediction Model Based on Magnetic Resonance Elastography-Assessed Liver Stiffness for Predicting Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

Non-invasive tests for the prediction of post-hepatectomy liver failure in the elderly

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