Yamanaka et al developed a score for estimating the risk of hepatic resection for a patient with liver cancer, either primary or metastatic. The authors are from Hyogo College of Medicine in Nishinomiya, Japan.
Parameters:
(1) parenchymal hepatic resection rate (PHRR), in percent, for the tumor-bearing lobe or segment
(2) indocyanine green dye retention rate at 15 minutes after injection of 0.5 mg/kg (ICG R15), in percent
(3) age in years
where:
• The parenchymal hepatic resection rate is calculated from CT slices using the formula in Okamoto et al (1984).
prediction score =
= (0.933 * (PHRR as a percent from 0 to 100)) + (1.11 * (ICG R15 as a percent from 0 to 100)) + (0.999 * (age in years)) – 84.6
Interpretation:
• All of the patients in the risky zone died, with the major cause being hepatic failure from excessive resection. Such patients may be candidates for liver transplantation.
Prediction Score
Interpretation
> 55
risky
45 – 55
borderline
< 45
safe
Adverse prognostic factors for patients with borderline or safe scores:
(1) disturbed glucose tolerance
(2) thrombocytopenia
(3) high indocyanine green dye retention (survivors had a score 16% +/- 4; nonsurvivors had a score 22% +/- 4.6)
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