Table 4.
Univariate and multivariate analysis of hepatic morbidity
| Variable | N | Hepatic morbidity | ||||
|---|---|---|---|---|---|---|
| Yes (N = 47) | No (N = 99) | UV P | MV P | RR (95% CI) | ||
| Patient factors | ||||||
| Gender | ||||||
| Male | 85 | 25 (53%) | 60 (61%) | 0.4 | – | – |
| Female | 61 | 22 (47%) | 39 (39%) | |||
| Age at hepatectomy (yr) | ||||||
| ≤60 | 78 | 22 (47%) | 56 (57%) | 0.27 | – | – |
| >60 | 68 | 25 (53%) | 43 (43%) | |||
| Liver metastases | ||||||
| Synchronousa | ||||||
| No | 35 | 7 (15%) | 28 (28%) | 0.08 | NS | – |
| Yes | 111 | 40 (85%) | 71 (72%) | |||
| Number | ||||||
| ≤3 | 62 | 17 (43%) | 45 (47%) | 0.6 | – | – |
| >3 | 73 | 23 (58%) | 50 (53%) | |||
| Maximum size (mm) | ||||||
| ≤30 | 50 | 17 (40%) | 33 (38%) | 0.9 | – | – |
| >30 | 79 | 26 (61%) | 53 (62%) | |||
| Localization | ||||||
| Unilobar | 44 | 13 (28%) | 31 (31%) | 0.65 | – | – |
| Bilobar | 102 | 34 (72%) | 68 (69%) | |||
| Initial resectability | ||||||
| No | 105 | 36 (77%) | 69 (70%) | 0.39 | – | – |
| Yes | 41 | 11 (23%) | 30 (30%) | |||
| Concomitant extrahepatic disease | ||||||
| No | 125 | 40 (87%) | 85 (86%) | 0.86 | – | – |
| Yes | 20 | 6 (13%) | 14 (14%) | |||
| Preoperative chemotherapy | ||||||
| No. of cycles | ||||||
| ≤9 | 87 | 26 (57%) | 61 (64%) | 0.38 | – | – |
| >9 | 54 | 20 (44%) | 34 (36%) | |||
| Regimen | ||||||
| 5-FU/LV and oxaliplatin | 92 | 33 (70%) | 59 (60%) | 0.21 | – | – |
| Other | 54 | 14 (30%) | 40 (40%) | |||
| Preoperative biochemical variables | ||||||
| ICG-R15 (%) | ||||||
| ≤10 | 22 | 10 (35%) | 12 (21%) | 0.19 | – | – |
| >10 | 63 | 19 (66%) | 44 (79%) | |||
| Platelet counta (103/μL) | ||||||
| ≤150 | 29 | 13 (33%) | 16 (17%) | 0.05 | 0.01 | 3.5 (1.3–9.2) |
| >150 | 103 | 27 (68%) | 76 (83%) | |||
| Prothrombin time (%) | ||||||
| ≤90 | 50 | 18 (41%) | 32 (36%) | 0.58 | – | – |
| >90 | 83 | 26 (59%) | 57 (64%) | |||
| ASTa (U/L) | ||||||
| ≤30 | 63 | 16 (36%) | 47 (51%) | 0.10 | NS | – |
| >30 | 75 | 29 (64%) | 46 (50%) | |||
| ALT (U/L) | ||||||
| ≤30 | 76 | 23 (51%) | 53 (57%) | 0.52 | – | – |
| >30 | 62 | 22 (49%) | 40 (43%) | |||
| AP (U/L) | ||||||
| ≤100 | 54 | 19 (48%) | 35 (45%) | 0.79 | – | – |
| >100 | 64 | 21 (53%) | 43 (55%) | |||
| GGT (U/L) | ||||||
| ≤80 | 79 | 28 (64%) | 51 (56%) | 0.4 | – | – |
| >80 | 56 | 16 (36%) | 40 (44%) | |||
| Total bilirubin (μmol/L) | ||||||
| ≤15 | 114 | 35 (78%) | 79 (85%) | 0.3 | – | – |
| >15 | 24 | 10 (22%) | 14 (15%) | |||
| Hepatectomy | ||||||
| Major resectiona (≥3 segments) | ||||||
| No | 73 | 17 (36%) | 56 (57%) | 0.02 | 0.05 | 2.6 (1–6.4) |
| Yes | 73 | 30 (64%) | 43 (43%) | |||
| Pedicular clamping | ||||||
| No | 43 | 10 (23%) | 33 (36%) | 0.12 | – | – |
| Yes | 93 | 34 (77%) | 59 (64%) | |||
| Combined local treatment | ||||||
| No | 129 | 43 (92%) | 86 (87%) | 0.42 | – | – |
| Yes | 17 | 4 (9%) | 13 (13%) | |||
| Portal vein embolization | ||||||
| No | 128 | 40 (85%) | 88 (89%) | 0.52 | – | – |
| Yes | 18 | 7 (15%) | 11 (11%) | |||
| Two-stage hepatectomya | ||||||
| No | 136 | 41 (87%) | 95 (96%) | 0.05 | 0.03 | 5.7 (1.2–27.2) |
| Yes | 10 | 6 (13%) | 4 (4%) | |||
| Intraoperative RBC transfusiona | ||||||
| No | 78 | 19 (43%) | 59 (67%) | 0.01 | 0.03 | 2.6 (1.1–6.1) |
| Yes | 54 | 25 (57%) | 29 (33%) | |||
| Nontumoral liver | ||||||
| Macrovacuolar steatosis (≤30%) | ||||||
| No | 134 | 44 (94%) | 90 (91%) | 0.58 | – | – |
| Yes | 12 | 3 (6%) | 9 (9%) | |||
| Fibrosis | ||||||
| No | 77 | 28 (60%) | 49 (50%) | 0.25 | – | – |
| Yes | 69 | 19 (40%) | 50 (51%) | |||
| Sinusoidal alterations | ||||||
| No | 130 | 43 (92%) | 87 (88%) | 0.51 | – | – |
| Yes | 16 | 4 (9%) | 12 (12%) | |||
| Peliosis | ||||||
| No | 101 | 31 (66%) | 70 (71%) | 0.56 | – | – |
| Yes | 45 | 16 (34%) | 29 (29%) | |||
| HCN | ||||||
| No | 109 | 37 (79%) | 72 (74%) | 0.49 | – | – |
| Yes | 36 | 10 (21%) | 26 (27%) | |||
| RNHa | ||||||
| No | 124 | 36 (77%) | 88 (89%) | 0.05 | NS | – |
| Yes | 22 | 11 (23%) | 11 (11%) | |||
UV univariate, MV multivariate, RR risk ratio, CI confidence interval, NS not significant, 5-FU/LV 5-fluorouracil/leucovorin, ICG-R15 indocyanine green retention rate at 15 minutes, AST aspartate aminotransferase, ALT alanine aminotransferase, AP alkaline phosphatase, GGT gamma-glutamyltransferase, RBC red blood cell, HCN hemorrhagic centrilobular necrosis, RNH regenerative nodular hyperplasia
aVariables entered in Cox regression model