Preoperative Systemic Pan-Immune-Inflammation Value Predicts Posthepatectomy Liver Failure After Laparoscopic Resection for Hepatocellular Carcinoma: A Retrospective Cohort Study.

Authors

Xiuyu Wu, Shun Xu, Tianqi Zhang, Ying Xing, Xia Min, Jingjing Wu, Qian Mao

Published in

Journal of inflammation research. Volume 19. Pages 600314. Epub Jun 24, 2026.

Abstract

Post-hepatectomy liver failure (PHLF) remains a major cause of morbidity after liver resection for hepatocellular carcinoma (HCC). Routine blood-count-based inflammatory indices may complement established liver reserve assessments. This study evaluated whether preoperative systemic pan-immune-inflammation value (S-PIV) predicts PHLF after conventional laparoscopic hepatectomy for HCC.
We conducted a single-center retrospective cohort study of consecutive patients who completed conventional laparoscopic hepatectomy for liver tumors between January 2017 and December 2025. Eligible patients had pathologically confirmed HCC and complete preoperative laboratory data within 7 days before surgery. Planned open hepatectomy, conversion to open surgery, and robotic-assisted hepatectomy were outside the predefined cohort scope. S-PIV was calculated as neutrophil count × monocyte count × platelet count / lymphocyte count. The primary outcome was ISGLS-defined PHLF, analyzed as any-grade PHLF versus no PHLF. Discrimination was assessed using ROC analysis, dose-response using restricted cubic splines, and clinical utility using decision curve analysis.
Among 582 screened patients, 356 were included; 68 (19.1%) developed PHLF. Preoperative S-PIV showed good discrimination for PHLF (AUC 0.873). The Youden index identified an optimal cut-off of 455.4, with sensitivity 0.726 and specificity 0.908. S-PIV showed higher AUCs than NLR (0.831) and PLR (0.848). Higher S-PIV was associated with PHLF in univariable analysis (per 100 units: OR 1.12, 95% CI 1.06-1.45; P<0.001) and remained independently associated after sequential adjustment for demographics/comorbidities, liver functional reserve, and tumor/operative factors (Model 3 per 100 units: OR 1.06, 95% CI 1.03-1.13; P<0.001). Restricted cubic splines showed a graded risk increase without evidence of nonlinearity, and decision curve analysis suggested net benefit across threshold probabilities of approximately 10%-70%.
Preoperative S-PIV, derived from routine blood counts, may serve as a practical adjunct for PHLF risk stratification after conventional laparoscopic hepatectomy for HCC. External multicenter validation and calibration are urgently required before routine implementation.

PMID:
42371494
Bibliographic data and abstract were imported from PubMed on 29 Jun 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.