Abstract
ObjectiveThe aim of this study was to investigate the prognostic significance of the serum γ-glutamyltransferase (γ-GT)-to-prealbumin ratio (GPR) and whether combining this ratio with other parameters can lead to an improved prognostic value for patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) combined with local ablation therapy.MethodsA total of 235 HCC patients who were treated with combined therapies were retrospectively analyzed. The demographic data and clinicopathological data were collected. A fibrinogen (Fib)-GPR score of 2 was assigned to patients with elevated Fib and GPR values, and a score of 1 or 0 was assigned to patients with one or neither of these two markers, respectively. In addition, an N-score of 2 was assigned to patients with low neutrophil and high GPR values, and a score of 1 or 0 was assigned to patients with one or neither of these two markers, respectively. The optimal cutoff values and prognostic roles of GPR and other markers were identified according to the time-dependent receiver operating characteristic (ROC) curves and Youden’s index.ResultsMultiple tumors, high levels of α-fetoprotein (AFP) and Fib, as well as a high GPR, were found to be independent risk factors in recurrent patients, while multiple tumors, a low neutrophil count, and a high GPR were associated with reduced overall survival (OS) in patients with HCC who received combined therapies. Patients with a Fib-GPR score of 2 and N-GPR score of 2 had poor recurrence-free survival (RFS) and OS, respectively.ConclusionsFib-GPR and N-GPR scores may be helpful in predicting both recurrence and the prognosis of HCC patients, thereby assisting in the process to make a true clinical decision and optimize therapeutic options.
Highlights
Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths and the sixth most common cancer worldwide, with approximately 841,000 new cases and 782,000 deaths annually [1]
Significant advances in locoregional therapies have led to excellent results with therapy that are highly comparable to those with surgical resection, especially in patients with small single tumors because the therapy are associated with minimal invasion, rapid recovery, and few complications
Clinical characteristics of HCC patients This cohort consisted of 183 males (77.9%) and 52 females (22.1%) with a mean age of 58 ± 8 years
Summary
Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths and the sixth most common cancer worldwide, with approximately 841,000 new cases and 782,000 deaths annually [1]. In China, HCC accounts for more than 83.9~92.3% of primary liver cancer cases and is currently a serious health problem [2, 3]. Significant advances in locoregional therapies have led to excellent results with therapy that are highly comparable to those with surgical resection, especially in patients with small single tumors because the therapy are associated with minimal invasion, rapid recovery, and few complications. Locoregional ablation plus transcatheter arterial chemoembolization (TACE), which can reduce the tumor bulk and heat sink effect, are potential treatment strategies for patients who are not eligible for surgical resection due to dysfunction or coagulopathy [4]. Valid markers for predicting patients’ prognosis are of great significance in choosing the optimal therapeutic modality
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