Liver Cancer Nomogram: Risk of Perioperative Transfusion in Hepatectomy

In the U.S.

Prediction Tools: DisclaimerThe prediction tools, also known as prognostic nomograms, located on the MSK Web site are for general health information only. The prediction tools are not to be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem.Users of the prediction tools should not rely on information provided by the prediction tools for their own health problems. Questions should be addressed to your own physician or other healthcare provider.MSK makes no warranties, nor express or implied representations whatsoever, regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced in the prediction tools. MSK does not assume any risk whatsoever for your use of the prediction tools or the information contained herein. Health related information changes frequently and therefore information contained in the prediction tools may be outdated, incomplete or incorrect.Use of the prediction tools does not create an express or implied physician-patient relationship. MSK does not endorse or claim validity for the prediction tools found on the MSK Web site. The activities and products of MSK and its developers and agents (collectively MSK) are not endorsed by our past, present, or future employers. MSK does not record specific prediction tool user information and does not contact users of the prediction tools.You are hereby advised to consult with a physician or other professional healthcare provider prior to making any decisions, or undertaking any actions or not undertaking any actions related to any healthcare problem or issue you might have at any time, now or in the future. In using the prediction tools, you agree that neither MSK nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to your use of any information presented in the prediction tools.

Our liver cancer nomogram is a tool designed to predict the likelihood of requiring a transfusion of red blood cells before, during, or shortly after a hepatectomy (surgery to remove part or all of the liver) for liver cancer. It is appropriate for patients undergoing a hepatectomy for primary and secondary tumors of the liver. If you are a patient, we recommend that you use this tool ONLY in consultation with your physician.

Results produced by this tool are based on data from patients treated at MSK, a large research institution with surgeons who perform a high volume of liver cancer procedures. All results must be understood in the context of each patient’s specific treatment plan. Patients and caregivers using this tool should discuss the result with the patient’s physician.

To gather the information required to use this nomogram, use our worksheet.

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All fields are required unless noted optional

What is the patient’s diagnosis?

Is there a need for an extrahepatic organ resection during the hepatectomy?

Yes

What is extrahepatic organ resection?: Extrahepatic organ resection refers to surgery to remove an organ situated outside the liver.

What is the planned number of liver segments to be resected during the hepatectomy? (0 to 6)

What is the patient’s hemoglobin level before the hepatectomy? g/mL (3 to 30)

What is hemoglobin?: Hemoglobin refers to a protein inside red blood cells that carries oxygen from the lungs to tissues and organs in the body, and carries carbon dioxide back to the lungs. Testing for the amount of hemoglobin in the blood is usually part of a complete blood count (CBC) test. It is used to check for conditions such as anemia, dehydration, and malnutrition.

What is the patient’s platelet count before the hepatectomy? x 10³/mm³ (20 to 1200)

What is a platelet?: A platelet refers to a tiny piece of a cell found in the blood that breaks off from a large cell found in the bone marrow. Platelets help wounds heal and prevent bleeding by forming blood clots.

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Supporting Publications

Risk of Perioperative Transfusion in Hepatectomy

Probability of requiring blood transfusion before, during,or shortly after hepatectomy for liver cancer

Source publication listed first, followed by external validation studies

Sima CS, Jarnagin WR, Fong Y, Elkin E, Fischer M, Wuest D, D'Angelica M, DeMatteo RP, Blumgart LH, Gönen M. Predicting the risk of perioperative transfusion for patients undergoing elective hepatectomy. Ann Surg. 2009 Dec;250(6):914-21. doi: 10.1097/sla.0b013e3181b7fad3. PMID: 19953711.

Frankel TL, Fischer M, Grant F, Krone J, D'Angelica MI, DeMatteo RP, Jarnagin WR, Gönen M. Selecting patients for acute normovolemic hemodilution during hepatic resection: a prospective randomized evaluation of nomogram-based allocation. J Am Coll Surg. 2013 Aug;217(2):210-20. doi: 10.1016/j.jamcollsurg.2013.03.019. Epub 2013 May 31. PMID: 23731968.

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Supporting Publications

Risk of Perioperative Transfusion in Hepatectomy