Preoperative Liver Function Guiding HCC Resection in Normal and Cirrhotic Liver

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Diagnostic Liver Function Testing

Background:

• Liver resection is a primary treatment for hepatocellular carcinoma (HCC).
• Accurate patient selection requires assessing resectability, recurrence risk, and liver function to prevent postoperative liver failure.
• The LiMAx® test is a reliable tool for preoperative liver function assessment, but its utility in HCC requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of the LiMAx® test in assessing liver function for hepatocellular carcinoma (HCC) patient selection.
• To compare LiMAx® test results in cirrhotic versus non-cirrhotic livers in HCC patients.
• To determine the impact of LiMAx® testing on clinical decisions regarding liver resection for HCC.

Main Methods:

• A cohort of 92 patients with HCC underwent LiMAx® testing between 2014 and 2019.
• Preoperative LiMAx® results were analyzed in relation to liver cirrhosis status.
• Clinical decisions for or against liver resection were correlated with LiMAx® values and other liver function parameters.

Main Results:

• Resected patients showed significantly higher LiMAx® results (388 vs. 322 µg/kg/h; p=0.004).
• LiMAx® values independently predicted the presence of liver cirrhosis.
• Seventeen patients had surgery cancelled due to impaired liver function; only 4/46 resected patients developed significant post-hepatectomy liver failure (PHLF).

Conclusions:

• Preoperative LiMAx® testing effectively identifies suitable candidates for HCC resection.
• The LiMAx® test facilitates safe patient selection in both cirrhotic and non-cirrhotic liver disease.
• This approach helps minimize the risk of post-hepatectomy liver failure in HCC patients.