Noninvasive tests for liver fibrosis predict postoperative complications after resection of colorectal liver metastases
Background: Colorectal liver metastases (CRLM) occur in up to 50% of patients who suffer from colorectal cancer. While liver resection of CRLM remains the only curative treatment option, postoperative complications are common and mitigate the beneficial effects of CRLM resection on quality of life a...
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| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
25 March 2026
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| In: |
Annals of surgical oncology
Year: 2026, Pages: 1-17 |
| ISSN: | 1534-4681 |
| DOI: | 10.1245/s10434-026-19338-1 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1245/s10434-026-19338-1
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| Author Notes: | Christopher Tuffs, MD, Oliver Marg, MD, Daniar Amin, MD, Tamal Sarkar, MSc, Christopher Schramm, MD, Alen Kosovic, MD, Jonathan M. Harnoss, MD, Christoph Kahlert, MD, Mohammed Al‑Saeedi, MD, Martin Reichert, MD, Andreas Hecker, MD, Elke Roeb, MD, Martin Schneider, MD, Moritz J. Strowitzki, MD, PhD |
| Summary: | Background: Colorectal liver metastases (CRLM) occur in up to 50% of patients who suffer from colorectal cancer. While liver resection of CRLM remains the only curative treatment option, postoperative complications are common and mitigate the beneficial effects of CRLM resection on quality of life and survival in these patients. Liver fibrosis is a known risk factor for surgical morbidity and mortality after liver surgery. However, preoperative detection of liver fibrosis remains challenging. Noninvasive tests facilitate the diagnosis of liver fibrosis without the need for liver biopsies and histological grading. We thus analyzed the significance of noninvasive tests for liver fibrosis, including FIB-4 index and SAFE score, to predict adverse short-term outcome after CRLM resection. Methods: A retrospective analysis of 107 patients who underwent surgery for CRLM at the Department for General, Visceral, Thoracic, and Transplantation Surgery of the University Hospital Giessen was performed to assess the correlation between suggested liver fibrosis as defined by noninvasive tests and short-term outcome. Results: A high FIB-4 index or SAFE score, predictive of liver fibrosis, was associated with increased incidence and severity of postoperative complications. These results were validated and confirmed in an external, independent patient cohort of 277 patients who underwent liver resection owing to CRLM at the Department for General, Visceral, and Transplantation Surgery of the University Hospital Heidelberg. Conclusion: Our findings provide a rationale for preoperative assessment of the FIB-4 index and SAFE score, as indicators of liver fibrosis, to identify CRLM patients at higher risk for postoperative complications. |
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| Item Description: | Online veröffentlicht: 25. März 2026 Gesehen am 27.04.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1534-4681 |
| DOI: | 10.1245/s10434-026-19338-1 |