Prediction of Long‐Term Prognosis in Patients With Hepatocellular Carcinoma Using the National Clinical Database Risk Calculator

ABSTRACT Aim To determine the value of the National Clinical Database (NCD) risk calculator for predicting surgical outcomes and long‐term prognosis in patients undergoing resection for hepatocellular carcinoma (HCC). Methods We retrospectively analyzed data from 210 patients with HCC who underwent initial hepatic resection between January 2016 and December 2022. We calculated predicted incidence of surgery‐related mortality (predicted mortality rate) using the NCD risk calculator. We assessed the relationship between predicted mortality rate and clinicopathological factors, including their relationship with long‐term prognosis. Results A predicted mortality rate of ≥ 3% significantly correlated with worse recurrence‐free survival and overall survival (OS), with a high‐risk group showing increased blood loss, longer hospital stays, and higher severe complication rates. Multivariate analysis identified predicted mortality rate of ≥ 3% as an independent prognostic indicator for poor OS, alongside male sex and microvascular invasion. Conclusion The NCD risk calculator showed potential to predict not only short‐term outcomes but also long‐term prognosis in patients with HCC undergoing resection. The NCD risk calculator may be a valuable complementary tool for decision‐making about liver resection in patients with HCC.