{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:31:13Z","timestamp":1768005073030,"version":"3.49.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p>Post-hepatectomy liver failure (PHLF) is a severe complication for hepatocellular carcinoma (HCC) patients post-surgery. This study explores PHLF risk factors and creates a nomogram for prediction using pre- and intraoperative factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 654 patients who underwent hepatectomy. Eligible patients were randomly divided into training and internal validation cohorts in a 7:3 ratio. Key variables for nomogram construction were determined through integrated Least Absolute Shrinkage and Selection Operator (LASSO) and multivariate logistic regression analyses. The nomogram's performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 228 eligible patients included in the study, 55 developed PHLF. Seven independent predictors were identified and incorporated into the nomogram: liver cirrhosis, total bilirubin (TBIL), prothrombin time (PT), Albumin-Bilirubin (ALBI), fibrosis-4 index (FIB4), ascites, and intraoperative blood loss. The nomogram demonstrated excellent predictive performance, with area under the curve (AUC) of 0.880 in the training cohort and 0.879 in the validation cohort. Calibration curve and decision curve analysis show that nomogram has significant clinical application value in predicting PHLF probability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We have developed and validated a novel PHLF risk prediction model that integrates pre-operative and intraoperative parameters, along with various liver function scoring systems, enabling more comprehensive and accurate prediction of PHLF risk in HCC patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1670396","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T05:51:29Z","timestamp":1759297889000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Establishing a nomogram for post-hepatectomy liver failure prediction in hepatocellular carcinoma based on pre-operative and perioperative parameters"],"prefix":"10.3389","volume":"12","author":[{"given":"Danni","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingmei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinxia","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhemei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3350\/cmh.2023.0125","article-title":"Recent advances in the management of hepatocellular carcinoma","volume":"30","author":"Sankar","year":"2024","journal-title":"Clin Mol Hepatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.ejca.2021.11.023","article-title":"Global, regional and national burden of primary liver cancer by subtype","volume":"161","author":"Rumgay","year":"2022","journal-title":"Eur J Cancer."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2643","DOI":"10.2147\/IJGM.S462844","article-title":"Impact of HBV integration on hepatocellular carcinoma after long-term antiviral therapy","volume":"17","author":"Wang","year":"2024","journal-title":"Int J Gen Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1186\/s12885-024-12535-9","article-title":"A novel surgical scheme for hepatectomy in hepatocellular carcinoma patients with clinically significant portal hypertension","volume":"24","author":"Ye","year":"2024","journal-title":"BMC Cancer."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1016\/j.hpb.2024.05.013","article-title":"Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma","volume":"26","author":"Huang","year":"2024","journal-title":"HPB."},{"key":"B6","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1097\/JS9.0000000000000873","article-title":"Short-term and long-term outcomes after robotic versus open hepatectomy in patients with large hepatocellular carcinoma: a multicenter study","volume":"110","author":"Zhang","year":"2024","journal-title":"Int J Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3078","DOI":"10.4240\/wjgs.v16.i10.3078","article-title":"Single incision laparoscopic surgery for hepatocellular carcinoma","volume":"16","author":"Karabicak","year":"2024","journal-title":"World J Gastrointest Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.4240\/wjgs.v16.i4.1087","article-title":"Construction of a predictive model for acute liver failure after hepatectomy based on neutrophil-to-lymphocyte ratio and albumin-bilirubin score","volume":"16","author":"Li","year":"2024","journal-title":"World J Gastrointest Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"366","DOI":"10.21037\/hbsn-23-95","article-title":"and Shelat V G. 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