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Article ; Online: Frailty assessment can predict textbook outcomes in senior adults after minimally invasive colorectal cancer surgery.

Taffurelli, Giovanni / Montroni, Isacco / Ghignone, Federico / Zattoni, Davide / Garutti, Anna / Di Candido, Francesca / Mazzotti, Federico / Frascaroli, Giacomo / Tamberi, Stefano / Ugolini, Giampaolo

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2022 Volume 49, Issue 3, Page(s) 626–632

Abstract: Aim: Colorectal cancer (CRC) surgery can be associated with suboptimal outcomes in older patients. The aim was to identify the correlation between frailty and surgical variables with the achievement of Textbook Outcome (TO), a composite measure of the ... ...

Abstract	Aim: Colorectal cancer (CRC) surgery can be associated with suboptimal outcomes in older patients. The aim was to identify the correlation between frailty and surgical variables with the achievement of Textbook Outcome (TO), a composite measure of the ideal postoperative course, by older patients with CRC. Method: All consecutive patients ≥70years who underwent elective CRC-surgery between January 2017 and November 2021 were analyzed from a prospective database. To obtain a TO, all the following must be achieved: 90-day survival, Clavien-Dindo (CD) < 3, no reintervention, no readmission, no discharge to rehabilitation facility, no changes in the living situation and length of stay (LOS) ≤5days/≤14days for colon and rectal surgery respectively. Frailty and surgical variables were related to the achievement of TO. Results: Four-hundred-twenty-one consecutive patients had surgery (97.7% minimally invasive), 24.9% for rectal cancer, median age 80 years (range 70-92), median LOS of 4 days (range 1-96). Overall, 288/421 patients (68.4%) achieved a TO. CD 3-4 complications rate was 6.4%, 90-day mortality rate was 2.9%. At univariate analysis, frailty and surgical variables (ileostomy creation, p = 0.045) were related to. However, multivariate analysis showed that only frailty measures such as flemish Triage Risk Screening Tool≥2 (OR 1.97, 95%CI: 1.23-3.16; p = 0.005); Charlson Index>6 (OR 1.61, 95%CI: 1.03-2.51; p = 0.036) or Timed-Up-and-Go>20 s (OR 2.06, 95%CI: 1.01-4.19; p = 0.048) independently predicted an increased risk of not achieving a TO. Conclusion: The association between frailty and comprehensive surgical outcomes offers objective data for guiding family counseling, managing expectations and discussing the possible loss of independence with patients and caregivers.
MeSH term(s)	Humans ; Adult ; Aged ; Aged, 80 and over ; Frailty/complications ; Retrospective Studies ; Postoperative Complications/etiology ; Digestive System Surgical Procedures/adverse effects ; Length of Stay ; Colorectal Neoplasms/surgery ; Risk Factors ; Geriatric Assessment ; Risk Assessment
Language	English
Publishing date	2022-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2022.11.006
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Article: Efficacy and Safety of Systemic Therapies for Advanced Hepatocellular Carcinoma: A Network Meta-Analysis of Phase III Trials.

Cucchetti, Alessandro / Piscaglia, Fabio / Pinna, Antonio Daniele / Djulbegovic, Benjamin / Mazzotti, Federico / Bolondi, Luigi

Liver cancer

2017 Volume 6, Issue 4, Page(s) 337–348

Abstract: Aim/background: After the introduction of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC), different studies tried to evaluate whether other systemic therapies can improve survival. To provide a comprehensive indirect treatment ... ...

Abstract	Aim/background: After the introduction of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC), different studies tried to evaluate whether other systemic therapies can improve survival. To provide a comprehensive indirect treatment comparison of efficacy and safety of novel drugs, a network meta-analysis (NMA) of phase III randomized controlled trials was performed. Methods: After pertinent literature search up to November 1, 2016, 6 studies were eligible for the analysis including 4,812 individual patients with advanced HCC: 2,454 received sorafenib, 577 received brivanib, 530 received sunitinib, 514 received linifanib, 358 received sorafenib + erlotinib and 379 received placebo. Frequentist NMA was used to compare treatments within a single analytical framework. Results: NMA showed that sorafenib alone, regardless of combination with erlotinib, and linifanib provide a significant survival advantage over placebo ( Conclusions: Sorafenib remains the best systemic treatment for advanced HCC; linifanib also resulted in survival advantages over placebo but with a lower safety profile.
Language	English
Publishing date	2017-10-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2666925-0
ISSN	1664-5553 ; 2235-1795
ISSN (online)	1664-5553
ISSN	2235-1795
DOI	10.1159/000481314
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Article ; Online: Years of Life Lost for Older Patients After Colorectal Cancer Diagnosis.

Mazzotti, Federico / Cucchetti, Alessandro / Claassen, Yvette H M / Bos, Amanda C R K / Bastiaannet, Esther / Ercolani, Giorgio / Dekker, Jan Willem T

World journal of surgery

2019 Volume 43, Issue 8, Page(s) 2077–2085

Abstract: Background: An aging population combined with an increased colorectal cancer (CRC) incidence in the older population will increase its prevalence in the elderly, questioning how many years of life are lost (YLLs) in these patients.: Patients and ... ...

Abstract	Background: An aging population combined with an increased colorectal cancer (CRC) incidence in the older population will increase its prevalence in the elderly, questioning how many years of life are lost (YLLs) in these patients. Patients and methods: Data from 32,568 Dutch CRC patients ≥ 80 years were used to estimate the number of YLLs after diagnosis, using a reference age-, sex- and year-of-onset-matched cohort derived from national life tables. YLLs were additionally adjusted by comorbidities. Number needed to treat (NNT) was used as measure of surgical effect size. Results: Surgery was applied in 74.9% of patients leading to 1.3 YLLs, being superior in 86.1% of cases with respect to alternative therapies (YLLs 4.8 years) and resulting in a number of two patients needed to operate to achieve one positive outcome. YLLs and NNTs depended on CRC stage, patient' age and comorbidities. For Stage I-II patients in the best clinical conditions (80-85 years without comorbidities), YLLs increased up to 4.1 years after surgery and up to 8.8 years without surgery (NNT 3). For Stage III patients, the NNT of surgery varied between 2 when they were in the best clinical conditions and 4 when they were older with high comorbidities. In Stage IV patients, the NNT ranged between 6 and 31. Conclusions: YLLs represents a novel approach to evaluate CRC prognosis. Stage I-III surgical patients can have a life expectancy similar to that of general population, being the NNT of surgery reasonably small compared with alternatives. Personalized comorbidity data are needed to confirm present findings.
MeSH term(s)	Aged, 80 and over ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/therapy ; Comorbidity ; Female ; Humans ; Life Expectancy ; Life Tables ; Male ; Neoplasm Staging ; Numbers Needed To Treat/statistics & numerical data ; Prognosis
Language	English
Publishing date	2019-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-019-04978-0
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Article: Efficacy and Safety of Systemic Therapies for Advanced Hepatocellular Carcinoma: A Network Meta-Analysis of Phase III Trials

Cucchetti, Alessandro / Piscaglia, Fabio / Pinna, Antonio Daniele / Djulbegovic, Benjamin / Mazzotti, Federico / Bolondi, Luigi

Liver Cancer

2017 Volume 6, Issue 4, Page(s) 337–348

Abstract: Aim/Background: After the introduction of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC), different studies tried to evaluate whether other systemic therapies can improve survival. To provide a comprehensive indirect treatment ... ...

Institution	Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy USF Health Program for Evidence-Based Medicine and Comparative Effectiveness Research, Division of Evidence-Based Medicine, Department of Internal Medicine, University of South Florida, and H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
Abstract	Aim/Background: After the introduction of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC), different studies tried to evaluate whether other systemic therapies can improve survival. To provide a comprehensive indirect treatment comparison of efficacy and safety of novel drugs, a network meta-analysis (NMA) of phase III randomized controlled trials was performed. Methods: After pertinent literature search up to November 1, 2016, 6 studies were eligible for the analysis including 4,812 individual patients with advanced HCC: 2,454 received sorafenib, 577 received brivanib, 530 received sunitinib, 514 received linifanib, 358 received sorafenib + erlotinib and 379 received placebo. Frequentist NMA was used to compare treatments within a single analytical framework. Results: NMA showed that sorafenib alone, regardless of combination with erlotinib, and linifanib provide a significant survival advantage over placebo (p < 0.05) but without any significant difference between each other. Conversely, all regimens significantly ameliorate progression-free survival versus placebo (p < 0.05). The rank order of efficacy was: sorafenib ± erlotinib, linifanib, brivanib, sunitinib, and placebo. Sorafenib ± erlotinib was the regimen with the fewest number of adverse events that required discontinuation of treatment, whereas linifanib and brivanib resulted in the most adverse events. The risk-benefit summary identified one cluster of therapies with a similar balance between efficacy and safety which included sorafenib alone or in combination with erlotinib, having, at the same time, the highest efficacy and safety. Conclusions: Sorafenib remains the best systemic treatment for advanced HCC; linifanib also resulted in survival advantages over placebo but with a lower safety profile.
Keywords	Hepatocellular carcinoma ; Systemic therapy ; Sorafenib ; Network meta-analysis ; Safety ; Survival
Language	English
Publishing date	2017-10-19
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Original Paper
ZDB-ID	2666925-0
ISSN	1664-5553 ; 2235-1795 ; 1664-5553
ISSN (online)	1664-5553
ISSN	2235-1795 ; 1664-5553
DOI	10.1159/000481314
Database	Karger publisher's database

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Article ; Online: Can Current Preoperative Imaging Be Used to Detect Microvascular Invasion of Hepatocellular Carcinoma?

Renzulli, Matteo / Brocchi, Stefano / Cucchetti, Alessandro / Mazzotti, Federico / Mosconi, Cristina / Sportoletti, Camilla / Brandi, Giovanni / Pinna, Antonio Daniele / Golfieri, Rita

Radiology

2016 Volume 279, Issue 2, Page(s) 432–442

Abstract: Purpose: To determine the accuracy of imaging features, such as tumor dimension, multinodularity, nonsmooth tumor margins, peritumoral enhancement, and radiogenomic algorithm based on the association between imaging features (internal arteries and ... ...

Abstract	Purpose: To determine the accuracy of imaging features, such as tumor dimension, multinodularity, nonsmooth tumor margins, peritumoral enhancement, and radiogenomic algorithm based on the association between imaging features (internal arteries and hypoattenuating halos) and gene expression that the authors called two-trait predictor of venous invasion (TTPVI), in the prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Materials and methods: This single-center retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. One hundred twenty-five patients (median age, 63 years; interquartile range, 53-71 years) with a diagnosis of HCC and indications for hepatic resection were included. Two observers independently reviewed radiologic images to evaluate the following features for MVI: maximum diameter, number of lesions, tumor margins, TTPVI, and peritumoral enhancement. Interobserver agreement was checked, and diagnostic accuracy of radiologic features was investigated. Results: The total number of HCC nodules was 140. Large tumor size, nonsmooth tumor margins, TTPVI, and peritumoral enhancement were significantly related to the presence of MVI (P < .05 in all cases and for both observers). Multinodularity was not significantly related (P = .158). Moreover, the diagnostic accuracy of the three "worrisome" radiologic features (nonsmooth tumor margins, peritumoral enhancement, and TTPVI) was associated with tumor size: The negative predictive value of the absence of worrisome features decreased from 0.84 for observer 1 and 0.91 for observer 2 for tumors smaller than 2 cm to 0.56 and 0.71, respectively, for tumors larger than 5 cm, whereas the presence of all three worrisome features returned to a positive predictive value of 0.95 for observer 1 and 0.96 for observer 2 independent of tumor size, with no significant interobserver differences (P > .10). Conclusion: "Worrisome" imaging features, such as tumor dimension, nonsmooth tumor margins, peritumoral enhancement, and TTPVI, have high accuracy in the prediction of MVI in HCC.
MeSH term(s)	Aged ; Algorithms ; Carcinoma, Hepatocellular/pathology ; Contrast Media ; Female ; Hepatectomy ; Humans ; Liver Neoplasms/pathology ; Magnetic Resonance Imaging ; Male ; Microvessels/pathology ; Middle Aged ; Neoplasm Invasiveness/diagnosis ; Neovascularization, Pathologic/diagnosis ; Preoperative Care ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed
Chemical Substances	Contrast Media
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2015150998
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Article ; Online: The use of the Hirsch index in benchmarking hepatic surgery research.

Cucchetti, Alessandro / Mazzotti, Federico / Pellegrini, Sara / Cescon, Matteo / Maroni, Lorenzo / Ercolani, Giorgio / Pinna, Antonio Daniele

American journal of surgery

2013 Volume 206, Issue 4, Page(s) 560–566

Abstract: Background: The Hirsch index (h-index) is recognized as an effective way to summarize an individual's scientific research output. However, a benchmark for evaluating surgeon scientists in the field of hepatic surgery is still not available.: Methods: ...

Abstract	Background: The Hirsch index (h-index) is recognized as an effective way to summarize an individual's scientific research output. However, a benchmark for evaluating surgeon scientists in the field of hepatic surgery is still not available. Methods: A total of 3,251 authors who published between 1949 and 2011 were identified using the Scopus identification number. The h-index, the total number of cited document, the total number of citations, and the scientific age were calculated for each author using both Scopus and Google Scholar. Results: The median h-index was 6 and the median scientific age, assessed with Google Scholar, was 19 years. The numbers of cited documents, numbers of citations, and h-indexes obtained from Scopus and Google Scholar showed good correlation with one another; however, the results from the 2 databases were modified in different ways by scientific age. By plotting scientific age against h-index percentiles an h-index growth chart for both Scopus database and Google Scholar was provided. Conclusions: This analysis provides a first benchmark to assess surgeon scientists' productivity in the field of liver surgery.
MeSH term(s)	Bibliometrics ; Databases, Bibliographic/statistics & numerical data ; Hepatectomy ; Humans ; Internet ; Liver Transplantation ; Publishing/statistics & numerical data
Language	English
Publishing date	2013-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2013.01.037
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Article ; Online: Adding Liver Stiffness Measurement to the Routine Evaluation of Hepatocellular Carcinoma Resectability Can Optimize Clinical Outcome.

Cucchetti, Alessandro / Cescon, Matteo / Colecchia, Antonio / Neri, Flavia / Cappelli, Alberta / Ravaioli, Matteo / Mazzotti, Federico / Ercolani, Giorgio / Festi, Davide / Pinna, Antonio Daniele

Ultraschall in der Medizin (Stuttgart, Germany : 1980)

2016 Volume 38, Issue 5, Page(s) 515–522

Abstract: ... ...

Title translation	Die Hinzunahme der Lebersteifigkeitsbestimmung bei der routinemäßigen Bewertung der Resektabilität von hepatozellulären Karzinomen kann den klinischen Erfolg verbessern.
Abstract	Purpose
MeSH term(s)	Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/surgery ; Elasticity Imaging Techniques ; Hepatectomy ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Postoperative Complications
Language	English
Publishing date	2016-05-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	801064-x
ISSN	1438-8782 ; 1439-0914 ; 1431-4894 ; 0172-4614
ISSN (online)	1438-8782
ISSN	1439-0914 ; 1431-4894 ; 0172-4614
DOI	10.1055/s-0042-104648
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Article ; Online: Hepatic venous pressure gradient in the preoperative assessment of patients with resectable hepatocellular carcinoma.

Cucchetti, Alessandro / Cescon, Matteo / Golfieri, Rita / Piscaglia, Fabio / Renzulli, Matteo / Neri, Flavia / Cappelli, Alberta / Mazzotti, Federico / Mosconi, Cristina / Colecchia, Antonio / Ercolani, Giorgio / Pinna, Antonio Daniele

Journal of hepatology

2016 Volume 64, Issue 1, Page(s) 79–86

Abstract: Backgrounds & aims: To assess the relationship existing between hepatic venous pressure gradient (HVPG) and the occurrence of post-hepatectomy liver failure (PHLF) grade B/C after resection of hepatocellular carcinoma (HCC) and persistent worsening of ... ...

Abstract	Backgrounds & aims: To assess the relationship existing between hepatic venous pressure gradient (HVPG) and the occurrence of post-hepatectomy liver failure (PHLF) grade B/C after resection of hepatocellular carcinoma (HCC) and persistent worsening of liver function. Methods: Data from 70 consecutive prospectively enrolled HCC patients undergoing resection were collected and analysed. PHLF grade B/C was defined by the International Study Group of Liver Surgery recommendations. The appearance of unresolved decompensation was also analysed. Results: Postoperative and 90-day mortality were null. The median HVPG value was 9mmHg (range: 4-18) and the median Model for End-stage Liver Disease (MELD) score was 8 (range: 6-14); 34 patients had an HVPG ⩾10mmHg (48.6%). Forty-nine patients had an uneventful (Grade A) postoperative course, including 17 with an HVPG ⩾10mmHg (24.2% of 70 patients). Grade B complications occurred in 20 patients (3 with an HVPG <10mmHg and 17 with an HVPG ⩾10mmHg; p<0.001); only one grade C complication occurred in a patient with an HVPG <10mmHg, subsequently successfully undergoing liver transplantation. Median MELD score returned to preoperative values after a transient postoperative increase, regardless of the HVPG values; after three months, it returned to the preoperative of 8 in patients with an HVPG <10mmHg and of 9 in patients with an HVPG ⩾10mmHg (p=0.077 and 0.076 at paired test, respectively). Conclusions: The hepatic venous pressure gradient can be used before surgery to stratify the risk of PHLF but the proposed cut-off of 10mmHg excludes approximately one-quarter of the patients who would benefit from surgery without short to mid-term postoperative sequelae.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/physiopathology ; Carcinoma, Hepatocellular/surgery ; Female ; Hepatic Veins/physiopathology ; Humans ; Liver Neoplasms/physiopathology ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Preoperative Care ; Prospective Studies ; Severity of Illness Index ; Venous Pressure/physiology
Language	English
Publishing date	2016-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605953-3
ISSN	1600-0641 ; 0168-8278
ISSN (online)	1600-0641
ISSN	0168-8278
DOI	10.1016/j.jhep.2015.08.025
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Article ; Online: Cure model survival analysis after hepatic resection for colorectal liver metastases.

Cucchetti, Alessando / Ferrero, Alessandro / Cescon, Matteo / Donadon, Matteo / Russolillo, Nadia / Ercolani, Giorgio / Stacchini, Giacomo / Mazzotti, Federico / Torzilli, Guido / Pinna, Antonio Daniele

Annals of surgical oncology

2015 Volume 22, Issue 6, Page(s) 1908–1914

Abstract: Background: Statistical cure is achieved when a patient population has the same mortality as cancer-free individuals; however, data regarding the probability of cure after hepatectomy of colorectal liver metastases (CLM) have never been provided. We ... ...

Abstract	Background: Statistical cure is achieved when a patient population has the same mortality as cancer-free individuals; however, data regarding the probability of cure after hepatectomy of colorectal liver metastases (CLM) have never been provided. We aimed to assess the probability of being statistically cured from CLM by hepatic resection. Methods: Data from 1,012 consecutive patients undergoing curative resection for CLM (2001-2012) were used to fit a nonmixture cure model to compare mortality after surgery to that expected for the general population matched by sex and age. Results: The 5- and 10-year disease-free survival was 18.9 and 15.8 %; the corresponding overall survival was 44.3 and 32.7 %. In the entire study population, the probability of being cured from CLM was 20 % (95 % confidence interval 16.5-23.5). After the first year, the mortality excess of resected patients, in comparison to the general population, starts to decline until it approaches zero 6 years after surgery. After 6.48 years, patients alive without tumor recurrence can be considered cured with 99 % certainty. Multivariate analysis showed that cure probabilities range from 40.9 % in patients with node-negative primary tumors and metachronous presentation of a single lesion <3 cm, to 1.5 % in patients with node positivity, and synchronous presentation of multiple, large CLMs. A model for the calculation of a cure fraction for each possible clinical scenario is provided. Conclusions: Using a cure model, the present results indicate that statistical cure of CLM is possible after hepatectomy; providing this information can help clinicians give more precise answer to patients' questions.
MeSH term(s)	Aged ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Female ; Follow-Up Studies ; Hepatectomy/mortality ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Models, Statistical ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Survival Rate
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-014-4234-0
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Article: Adding Liver Stiffness Measurement to the Routine Evaluation of Hepatocellular Carcinoma Resectability Can Optimize Clinical Outcome

Cucchetti, Alessandro / Cescon, Matteo / Colecchia, Antonio / Neri, Flavia / Cappelli, Alberta / Ravaioli, Matteo / Mazzotti, Federico / Ercolani, Giorgio / Festi, Davide / Pinna, Antonio Daniele

Ultraschall in der Medizin - European Journal of Ultrasound

2016 Volume 38, Issue 05, Page(s) 515–522

Abstract: Purpose: Liver stiffness (LS) has been shown to be of use in chronic liver disease patients but its utility in surgical judgment still needs to be proven. A decision-making approach was applied to evaluate whether LS measurement before surgery of ... ...

Abstract	Purpose: Liver stiffness (LS) has been shown to be of use in chronic liver disease patients but its utility in surgical judgment still needs to be proven. A decision-making approach was applied to evaluate whether LS measurement before surgery of hepatocellular carcinoma (HCC) can be useful in avoiding post-hepatectomy liver failure (PHLF). Materials and Methods: Decision curve analysis (DCA) was applied to 202 HCC patients (2008 – 14) with LS measurement prior to hepatectomy to verify whether the occurrence of PHLF grades B/C should be reduced through a decision-making approach with LS. Results: Within 90 days of surgery, 4 patients died (2 %) and grades B/C PHLF occurred in 29.7 % of cases. Ascites and/or pleural effusion, treatable with medical therapy, were the most frequent complications. DCA showed that using the “expected utility theory” LS measurement can reduce up to 39 % of cases of PHLF without the exclusion of any patient from surgery that duly undergoes an uncomplicated postoperative course. LS measurement does not add any information to normal clinical judgment for patients with a low (< 10 %) risk of PHLF. Conclusion: LS measurement can determine a reduction of PHLF under “expected utility theory” fulfilment. However, the degree of PHLF can be minor and “risk seeking” individuals can accept such a risk on the basis of surgical benefits.
Keywords	abdomen ; liver stiffness ; hepatocellular carcinoma ; hepatic resection ; decision analysis
Language	English
Publishing date	2016-05-03
Publisher	© Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	801064-x
ISSN	1438-8782 ; 0172-4614 ; 1439-0914 ; 1431-4894
ISSN (online)	1438-8782
ISSN	0172-4614 ; 1439-0914 ; 1431-4894
DOI	10.1055/s-0042-104648
Database	Thieme publisher's database

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