Table 1.
The clinical and pathological data of the study patients
| Variable | Training cohort (n = 181) | Internal validation cohort (n = 100) | External validation cohort (n = 112) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Without PHLF (n = 116) | With PHLF (n = 65) | p value | Without PHLF (n = 71) | With PHLF (n = 29) | p value | Without PHLF (n = 80) | With PHLF (n = 32) | p value | |
| Age (years) | 54.81 ± 11.44 | 51.66 ± 10.83 | 0.072 | 55.77 ± 11.88 | 54.14 ± 9.52 | 0.511 | 54.38 ± 12.91 | 54.09 ± 13.20 | 0.918 |
| Male (N) | 94 (81.03%) | 56 (86.15%) | 0.380 | 65 (91.55%) | 25 (86.21%) | 0.419 | 61 (76.25%) | 28 (87.50%) | 0.183 |
| PLT count (109/L) | 164.50 (129.00, 205.25) | 167.00 (131.50, 196.50) | 0.920 | 147 (101, 193) | 143 (93, 179) | 0.352 | 179.50 (145.50, 212.50) | 173.00 (137.00, 198.00) | 0.704 |
| Serum ALT (μmol/L) | 36.00 (25.00, 53.00) | 44.00 (28.65, 65.00) | 0.065 | 32 (24, 42) | 31 (27, 47) | 0.521 | 35.00 (26.00, 47.00) | 42.50 (28.88, 74.00) | 0.091 |
| Serum AST (μmol/L) | 35.00 (26.00, 50.00) | 44.00 (28.00, 61.70) | 0.059 | 31 (24, 51) | 34 (26, 50) | 0.427 | 37.00 (26.00, 57.03) | 43.50 (26.05, 61.85) | 0.664 |
| Serum Alb (g/L) | 40.49 ± 5.35 | 38.69 ± 5.47 | 0.033* | 40.07 ± 4.91 | 37.86 ± 4.75 | 0.042 | 42.25 ± 4.49 | 40.61 ± 4.90 | 0.091 |
| Serum Tbil (μmol/L) | 13.96 (11.40, 18.51) | 15.57 (10.73, 29.69) | 0.198 | 14.00 (9.15, 19.75) | 20.71 (16.19, 30.80) | < 0.001 | 13.22 (10.35, 15.16) | 15.81 (11.88, 28.99) | 0.001 |
| Serum Cr (μmol/L) | 67.00 (55.63, 75.80) | 65.20 (54.60, 72.35) | 0.304 | 68.00 (59.60, 80.00) | 70.50 (56.00, 85.15) | 0.958 | 63.25 (51.66, 72.24) | 65.30 (52.35, 71.37) | 0.995 |
| Serum Hct (L/L) | 0.41 (0.36, 0.45) | 0.41 (0.37, 0.44) | 0.727 | 0.38 (0.30, 0.43) | 0.43 (0.36, 0.44) | 0.079 | 0.40 (0.32, 0.43) | 0.41 (0.38, 0.43) | 0.177 |
| Serum INR | 0.98 (0.92, 1.07) | 0.97 (0.91, 1.05) | 0.374 | 1.02 (0.97, 1.08) | 0.99 (0.95, 1.06) | 0.175 | 1.08 (1.02, 1.13) | 1.10 (1.02, 1.16) | 0.713 |
| Serum PT (s) | 11.60 (10.90, 12.58) | 11.40 (10.65, 12.10) | 0.067 | 12.00 (11.50, 13.00) | 11.70 (11.30, 12.05) | 0.080 | 11.60 (10.90, 12.67) | 11.35 (10.55, 11.98) | 0.069 |
| Serum PTA (%) | 92.38 ± 18.24 | 96.72 ± 14.60 | 0.102 | 86.69 ± 13.44 | 88.90 ± 12.83 | 0.451 | 91.37 ± 16.75 | 97.78 ± 16.90 | 0.071 |
| Operation time, surgery (min) | 357.00 (266.25, 504.25) | 425 (270, 529) | 0.288 | 392 (285, 497) | 350 (228, 450) | 0.220 | 297.50 (210.75, 450.00) | 427.50 (281.25, 599.00) | 0.013 |
| Hepatic inflow occlusion duration | 0 (0, 50) | 30 (15, 66) | < 0.001* | 0 (0, 0) | 45.00 (15.00, 75.00) | < 0.001 | 0 (0, 23.75) | 15.00 (0, 44.25) | 0.024 |
| Blood loss, surgery (mL) | 200 (100, 400) | 300 (110, 500) | 0.164 | 200 (100, 400) | 200 (100, 250) | 0.152 | 200 (100, 475) | 300 (123, 500) | 0.134 |
| Blood transfusion, surgery (mL) | 0 (0, 0) | 0 (0, 0) | 0.495 | 0 (0, 0) | 0 (0, 0) | 0.663 | 0 (0, 0) | 0 (0, 0) | 0.764 |
| Hepatectomy, surgery | < 0.001* | 0.014 | 0.153 | ||||||
| Minor hepatectomy | 101 (87.07%) | 34 (52.31%) | 60 (84.51%) | 18 (62.07%) | 67 (83.75%) | 23 (71.88%) | |||
| Major hepatectomy | 15 (12.93%) | 31 (47.69%) | 11 (15.49%) | 11 (37.93%) | 13 (16.25%) | 9 (28.12%) | |||
| Hypertension (N) | 23 (19.83%) | 9 (13.85%) | 0.312 | 8 (11.27%) | 4 (13.79%) | 0.724 | 11 (13.75%) | 3 (9.38%) | 0.754 |
| Diabetes mellitus (N) | 13 (11.21%) | 3 (4.62%) | 0.134 | 5 (7.04%) | 0 | 0.337 | 9 (11.25%) | 2 (6.25%) | 0.651 |
| The presence of viral hepatitis (N) | 85 (73.28%) | 38 (58.46%) | 0.060 | 51 (71.83%) | 22 (75.86%) | 0.680 | 58 (72.50%) | 20 (62.50%) | 0.298 |
| Maximum diameter, pathology (cm) | 4.00 (2.35, 7.00) | 4.50 (2.50, 8.90) | 0.344 | 4.50 (2.50, 8.00) | 5.30 (2.50, 6.50) | 0.933 | 4.75 (2.35, 8.00) | 3.25 (2.28, 6.45) | 0.242 |
| Fibrosis stage, pathology | 0.022* | 0.009 | 0.009 | ||||||
| S0 | 42 (36.21%) | 16 (24.62%) | 31 (43.66%) | 3 (10.34%) | 41 (51.25%) | 5 (15.63%) | |||
| S1 | 17 (14.66%) | 11 (16.92%) | 4 (5.63%) | 1 (3.45%) | 11 (13.75%) | 6 (18.75%) | |||
| S2 | 27 (23.28%) | 7 (10.77%) | 7 (9.86%) | 3 (10.34%) | 10 (12.50%) | 5 (15.63%) | |||
| S3 | 13 (11.21%) | 15 (23.08%) | 10 (14.08%) | 6 (20.69%) | 10 (12.50%) | 8 (25.00%) | |||
| S4 | 17 (14.66%) | 16 (24.62%) | 19 (26.76%) | 16 (55.17%) | 8 (10.00%) | 8 25.00%) | |||
| Steatosis, pathology (N) | 8 (6.90%) | 4 (6.15%) | 0.847 | 4 (5.63%) | 0 | 0.458 | 8 (10.00%) | 3 (9.38%) | 0.920 |
| Tumor thrombus, pathology (N) | 30 (25.86%) | 25 (38.46%) | 0.077 | 19 (26.76%) | 9 (31.03%) | 0.666 | 21 (26.25%) | 9 (28.13%) | 0.840 |
| Clinical models | |||||||||
| Child − Pugh stage | 0.559 | 0.139 | 0.791 | ||||||
| A | 102 (87.93%) | 59 (90.77%) | 63 (88.73%) | 29 (100%) | 76 (95.00%) | 30 (93.75%) | |||
| B | 14 (12.07%) | 6 (9.23%) | 8 (11.27%) | 0 | 4 (5.00%) | 2 (6.25%) | |||
| MELD score | 15.89 ± 4.57 | 15.39 ± 4.56 | 0.476 | 16.40 ± 4.46 | 17.78 ± 2.98 | 0.132 | 15.73 ± 4.15 | 17.44 ± 5.03 | 0.066 |
| ALBI score | − 2.67 (− 2.98, − 2.40) | − 2.56 (− 2.82, − 1.99) | 0.010* | − 2.62 (− 2.94, − 2.36) | − 2.17 (− 2.67, − 2.05) | 0.001 | − 2.86 (− 3.11, − 2.61) | − 2.67 (− 2.95, − 2.28) | 0.008 |
Note: Data are presented as n (percentage), median (interquartile range), or mean ± standard deviation
Abbreviations: PHLF Posthepatectomy liver failure, PLT counts Platelet counts, ALT Alanine aminotransferase, AST Aspartate aminotransferase, Alb Albumin, Cr Creatinine, Tbil Total bilirubin, Hct Hematocrit, INR, International normalized ratio, PT Prothrombin time, PTA Prothrombin activity, MELD Model for end-stage liver disease, ALBI Albumin–bilirubin
*The comparison between patients without PHLF and patients with PHLF in the training cohort. p value < 0.05 means significant