Abstract
BackgroundTo analyze prognostic factors following hepatic resection in patients with HBV-related hepatocellular carcinoma.MethodsWe retrospectively analyzed 217 patients with HBV-related hepatocellular carcinoma who underwent hepatic resection at our hospital between January 2006 and December 2015. Disease-free survival and overall survival rates were analyzed using the Kaplan–Meier method and the log-rank test. The association between recurrence and survival and various clinicopathological factors, including serum alpha-fetoprotein (AFP) level, platelet count, platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, antiplatelet therapy, antiviral therapy, hepatitis C virus infection, and tumor-related characteristics, were assessed using univariate and multivariate logistic regression analysis.ResultsThe 1-, 3-, and 5-year overall survival rates were 91, 84, and 79%, respectively, and the recurrence-free survival rates were 72, 51, and 44%, respectively. High post-operative AFP level (hazard ratio [HR] 1.112, 95% confidence interval [CI]: 1.02–1.21, P = 0.007), multiple tumors (HR 1.991, 95% CI: 1.11–3.56, P = 0.021), and no antiviral treatment (HR 1.823, 95% CI: 1.07–3.09, P = 0.026) were independent risk factors for recurrence. High post-operative AFP level (HR 1.222, 95% CI: 1.09–1.36, P < 0.001), multiple tumors (HR 2.715, 95% CI: 1.05–7.02, P = 0.039), and recurrence (HR 12.824, 95% CI: 1.68–97.86, P = 0.014) were independent risk factors for mortality. No other factors analyzed were associated with outcomes in this patient cohort.ConclusionsHigh post-operative serum alpha-fetoprotein level and multiple tumors, but not inflammatory factors, were risk factors for poor prognosis in HBV-related hepatocellular carcinoma patients after resection.
Highlights
To analyze prognostic factors following hepatic resection in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma
We investigated the prognostic value of platelet counts, antiplatelet therapy, inflammatory indices, and various tumor-related characteristics in patients with HBV-related Hepatocellular carcinoma (HCC) following hepatic resection
Univariate analysis (Table 3) identified the following factors as significantly associated with disease recurrence: post-operative AFP level (HR 1.112, 95% confidence intervals (CI): 1.02–1.21, P = 0.012), tumor size (HR 1.061, 95% CI: 1.01–1.11, P = 0.013), multiple tumors (HR 1.881, 95% CI: 1.23–2.86, P = 0.003), microvascular invasion (HR 1.645, 95% CI: 1.02–2.63, P = 0.037), stage II or higher (HR 1.553, 95% CI 1.04–2.31, P = 0.031), and no antiviral treatment (HR 1.519, 95% CI: 1.01–2.28, P = 0.045)
Summary
To analyze prognostic factors following hepatic resection in patients with HBV-related hepatocellular carcinoma. Chronic hepatitis [7, 8], and Inflammation is a key contributor to the pathogenesis of HCC in patients with chronic HBV infection [10,11,12]. Many studies have investigated the utility of inflammatory factors and indices as prognostic markers for HBV-related HCC patients following hepatic resection; the results are controversial [13,14,15,16,17,18,19]. Recent reports suggest that platelets play a major role in the pathogenesis of HCC in HBV-infected patients [20, 21]. Lee et al reported that HBV-related HCC patients
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