The Value Of Albumin-Indocyanine Green Evaluation(ALICE)System In Hepatectomy Of Hepatocellular Carcinoma With Portal Hypertension

Aim:The aim of this study was to evaluate the value of the ALICE score system in predicting the postoperative complications and survival rate in patients with portal hypertension(PH)and hepatocellular carcinoma(HCC)Method:Patients with HCC and PH undergoing hepatectomy in Shengjing Hospital Affiliated of China Medical University were analyzed retrospectively between June 2012 and June 2019.The clinical information,imaging examination,laboratory examination,surgical information and postoperative complications of all patients were recorded and compared.The ability to predict postoperative complications was compared with ALBI and Child-Pugh.According to the follow-up data,the survival curve of ALICE was drawn and the difference was comparedResults:Among the 92 patients included,there were 3 cases with postoperative complications of grade ?a or above,1 case of perioperative death and 19 cases with PHLF.The area under the working curve of subjects with ALICE score,ALBI score and Child-Pugh score was 0.756 0.726 and 0.577,respectively.The area under the working curve of subjects with Alice score and child-Pugh score was significantly different(P=0.002).Multivariate analysis showed that elevated total bilirubin(OR=1.085;95%CI:1.023,1.152,P=0.007)and long operation time(OR=1.017;95%CI:1.006,1.028,P=0.002)were independent risk factors.The 1-year,2-year and 3-year overall survival rates of patients with level 1 were 91.1%,84.7%and 81.6%respectively,while the 1-year,2-year and 3-year overall survival rates of patients with level 2 were 75.7%,65.5%and 45.8%,and the survival curves of level 1 and level 2 were statistically different(P=0.008),The 1-year,2-year and 3-year recurrence-free survival rates of patients with level 1 were 80.6%,76.4%and 64.9%respectively.While the 1-year,2-year and 3-year recurrence-free survival rates of patients with level 2 were 57.7%,32.6%and 21.8%respectively.and the survival curves of level 1 and level 2 were statistically different(P=0.002)Conclusion:ALICE score system in HCC with PH hepatectomy can well predict postoperative liver failure,and has a good stratification effect on the overall survival rate and tumor recurrence free survival rate.