Novel scoring system accurately predicts risk of failure to achieve textbook outcomes after hepatectomy for hepatocellular carcinoma

A multicenter study developed and validated a scoring system to predict the risk of not achieving textbook outcomes (non-TOS) following hepatectomy for hepatocellular carcinoma (HCC). The scoring system, based on factors like obesity, ASA score, Child-Pugh grade, tumor size, and extent of hepatectomy, accurately stratified patients into low, intermediate, and high-risk categories for non-TOS. The novel system identified 39.6% of patients who failed to experience a textbook outcome, with the predicted and observed risks closely matching in the validation cohort. This score may aid in early risk identification and surgical decision-making for HCC patients.