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Prediction of Long-Term Prognosis in Patients With Hepatocellular Carcinoma Using the National Clinical Database Risk
Mariko Tsukagoshi1, Kenichiro Araki1, Norio Kubo1
1Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science Gunma University Graduate School of Medicine Maebashi Gunma Japan.
Annals of Gastroenterological Surgery
|July 28, 2026
Summary
The National Clinical Database (NCD) risk calculator accurately predicts surgical outcomes and long-term survival for hepatocellular carcinoma (HCC) patients undergoing resection. A predicted mortality rate of 3% or higher indicates a worse prognosis.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Clinical informatics
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer with significant global impact.
- Surgical resection is a primary treatment modality for resectable HCC.
- Accurate prediction of surgical outcomes and long-term prognosis is crucial for patient management.
Purpose of the Study:
- To evaluate the National Clinical Database (NCD) risk calculator's efficacy in predicting surgical outcomes and long-term prognosis.
- To assess the correlation between predicted mortality rates and patient outcomes in HCC resection.
- To determine the NCD risk calculator's utility as a decision-making tool for HCC liver resection.
Main Methods:
- Retrospective analysis of 210 HCC patients undergoing initial hepatic resection (January 2016 - December 2022).
- Calculation of predicted surgical mortality rates using the NCD risk calculator.
- Assessment of relationships between predicted mortality, clinicopathological factors, and long-term prognosis (recurrence-free and overall survival).
Main Results:
- A predicted mortality rate of ≥3% significantly correlated with worse recurrence-free and overall survival (OS).
- Patients in the high-risk group (≥3% predicted mortality) experienced increased blood loss, longer hospital stays, and higher severe complication rates.
- Multivariate analysis identified predicted mortality rate (≥3%) as an independent prognostic indicator for poor OS, alongside male sex and microvascular invasion.
Conclusions:
- The NCD risk calculator demonstrates potential in predicting both short-term surgical outcomes and long-term prognosis for HCC patients.
- The NCD risk calculator can serve as a valuable supplementary tool for clinical decision-making in liver resection for HCC.
- Integration of the NCD risk calculator may enhance personalized treatment strategies and improve patient outcomes in HCC management.