Abstract
Although Metavir and Fibrosis-4 (FIB-4) scores are typically used to assess the severity of liver fibrosis, the relationship between these scores and patient outcome in hepatocellular carcinoma (HCC) is unclear. The aim of this study was to evaluate the prognostic value of the severity of hepatic fibrosis in HBV-related HCC patients after curative resection. We examined the prognostic roles of the Metavir and preoperative FIB-4 scores in 432 HBV-HCC patients who underwent curative resection at two different medical centers located in western (Chongqing) and eastern (Shanghai) China. In the testing set (n = 108), the Metavir, FIB-4, and combined Metavir/FIB-4 scores were predictive of overall survival (OS) and recurrence-free survival (RFS). Additionally, they were associated with several clinicopathologic variables. In the validation set (n = 324), the Metavir, FIB-4, and combined Metavir/FIB-4 scores were associated with poor prognosis in HCC patients after curative resection. Importantly, in the negative alpha-fetoprotein subgroup (≤ 20 ng/mL), the FIB-4 index (I vs. II) could discriminate between patient outcomes (high or low OS and RFS). Thus Metavir, preoperative FIB-4, and combined Metavir/FIB-4 scores are prognostic markers in HBV-HCC patients after curative hepatectomy.
Highlights
Hepatocellular carcinoma (HCC) is a type of primary liver cancer that can result from chronic inflammation induced by hepatitis B or C virus (HBV or HCV) infection
The outcomes of the majority of HCC patients are closely associated with cancer and cirrhosis, the potential contribution of cirrhosis to post-operative recurrence has not been adequately evaluated
Several clinical studies have demonstrated that the Ishak stage [13] and LSM [14, 15, 29] are useful predictors of HCC prognosis
Summary
Hepatocellular carcinoma (HCC) is a type of primary liver cancer that can result from chronic inflammation induced by hepatitis B or C virus (HBV or HCV) infection. Despite the multiple treatment options for HCC and advances in surgical techniques, HCC patients with cirrhosis have a poor prognosis when diagnosed in a symptomatic phase [3]. Several risk factors for HCC have been identified previously. These include clinical characteristics (e.g. male sex, cirrhosis, elevated serum gamma-glutamyltransferase, and high HBV load) [4,5,6,7] and various molecular markers [8, 9]. HCC is characterized by a high frequency of fibrosis and cirrhosis, which may impact the local host inflammatory/immune microenvironment. In response to chronic injury induced by fibrosis or cirrhosis, www.impactjournals.com/oncotarget
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