Abstract
Background Previous studies demonstrated a promising prognosis of advanced hepatocellular carcinoma (HCC) patients underwent surgery, yet a consensus of appropriate criteria for surgery was unreached. This study aimed at establishing a prognostic score to select candidates for surgery in advanced HCC. Methods From May 30th, 1995 to June 1st, 2017, 496 advanced HCC patients who initially underwent liver resection were consecutively collected at the First Affiliated Hospital of Sun-Yat Sen University. Patients were randomly divided into the training group (n=347) and the validation group (n=149). Least absolute shrinkage and selection operator (LASSO) regression followed by a stepwise analysis were performed to select pre-operative factors to build a prognostic score for recurrence-free survival (RFS). Results Seven factors were selected to construct the score, which were the albumin-bilirubin (ALBI) grade≥2, tumor size≥5 cm, the number of tumor-invaded liver segment≥3, hemoglobin Conclusions Surgery could provide promising survival for selective HCC patients in the advanced stage. We constructed a well-validated score to identify appropriate candidates for surgery in the advanced HCC patients. Surgery for patients in the low-risk group is recommended according to our results.
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