A Novel Blood Index-Based Model to Predict Hepatitis B Virus-Associated Hepatocellular Carcinoma Recurrence After Curative Hepatectomy: Guidance on Adjuvant Transcatheter Arterial Chemoembolization Choice.

Yiping Zou,Qi Lou,Zuyi Ma,Yuanpeng Zhang,Hongwei Han,Zhihong Chen,Ning Shi,Zhenrong Chen,Haosheng Jin

doi:10.3389/fonc.2021.755235

Abstract

BackgroundPostoperative recurrence is a significant obstacle in hepatocellular carcinoma (HCC) treatment. This study aimed to construct a blood index-based model to predict hepatitis B virus-associated HCC (HBV-HCC) recurrence after curative hepatectomy.MethodsA total of 370 patients who received initially curative hepatectomy for HBV-HCC were included in this study. A novel blood index signature (BIS) was identified and systematically analyzed for its recurrence predictive value. Following this, multivariate Cox regression analysis was performed to build a blood index-based nomogram.ResultsA BIS based on the aminotransferase-to-platelet ratio index and a systemic inflammatory response index was used to construct a nomogram. The model showed good clinical applicability and reliability. Notably, the patients in the high recurrence risk group tended to benefit from adjuvant transcatheter arterial chemoembolization (TACE).ConclusionA reliable model was constructed to predict the HBV-HCC recurrence after curative hepatectomy. This model can guide the surgeons in selecting patients with high recurrence risk patients who may benefit from adjuvant TACE.

Highlights

Hepatocellular carcinoma (HCC), the fourth common cause of cancer worldwide, causes more than 600,000 deaths annually
Several studies have reported on adjuvant therapeutic modalities, the role of adjuvant transcatheter arterial chemoembolization (TACE) in resectable HCC remains controversial [7,8,9], which can be attributed to the considerable heterogeneity of HCC
The results indicated blood index signature (BIS) levels were significantly higher in patients with AFP positive values, grade III/IV, microvascular invasions (MVIs), and tumor size ≥5 cm (p < 0.001) (Figures 2A–F)

Summary

Introduction

Hepatocellular carcinoma (HCC), the fourth common cause of cancer worldwide, causes more than 600,000 deaths annually. Regarding HCC treatment, only curative resection allows patients with HCC to achieve long-term survival. The postoperative high recurrence rate is a significant obstacle in cancer management [3, 4]. Identifying novel biomarkers and constructing an accurate prediction model based on postoperative HCC recurrence provide physicians with more appropriate therapeutic options. Peripheral blood microRNAs were identified as prognostic predictors in patients with HCC who received TACE [10]. The result showed that miR-21 and miR-122 were prognostic biomarkers in HCC patients treated with TACE and correlated with hypoxia-inducible factor-1a (HIF-1a) serum levels. Postoperative recurrence is a significant obstacle in hepatocellular carcinoma (HCC) treatment. This study aimed to construct a blood index-based model to predict hepatitis B virus-associated HCC (HBV-HCC) recurrence after curative hepatectomy

Objectives

Methods

Results

Discussion

Conclusion