Abstract
BackgroundMultiple studies have reported that tissue or serum osteoprotegerin (OPG) level is a prognostic factor for patients with cancer. However, little is known about the role of serum OPG in hepatocellular carcinoma (HCC). In this study, we aimed to investigate whether serum OPG concentration has an effect on HCC patients’ prognosis.MethodsA total of 386 eligible HCC patients undergoing radical hepatectomy were enrolled from Shanghai Ninth People’s Hospital and Zhongshan Hospital between 2010 and 2018. Kaplan-Meier curves, Cox regression model, and the restricted mean survival time (RMST) were used to estimate the association of OPG and HCC patients’ survival outcome. In addition, sensitivity analyses were carried out including subgroup analysis and propensity score matching (PSM).ResultsPatients were separated into two groups according to the cut-off value of OPG calculated by X-tile. Multivariate Cox analysis showed that patients with high OPG level had worse overall survival (OS) (HR: 1.93; 95% CI: 1.40–2.66, p<0.001) and disease-free survival (DFS) (HR: 1.85; 95% CI: 1.39–2.47, p<0.001) before matching. On average, RMST ratio between high and low OPG turned out to be 0.797 (95% CI: 0.716–0.887, p<0.001). In the matched population, we found that OPG level was negatively associated with OS (HR: 1.85; 95% CI: 1.25–2.74, p=0.002) and DFS (HR: 1.71; 95% CI: 1.20–2.44, p=0.003). In addition, a similar trend was further confirmed by subgroup analyses.ConclusionIn a word, HCC patients with high OPG level had poorer survival rates compared with HCC patients with low OPG level. This factor could act as a potential prognostic predictor for HCC patients who underwent radical resection in the future.
Highlights
It is reported that the incidence of hepatocellular carcinoma (HCC) ranks sixth along with the mortality rate ranking third among all malignant cancers worldwide
A total of 386 HCC patients who met our inclusion criteria were enrolled in this study
Confirmed microvascular invasion was detected in 264 HCC patients (68.39%) and absent in 122 patients (31.61%)
Summary
It is reported that the incidence of hepatocellular carcinoma (HCC) ranks sixth along with the mortality rate ranking third among all malignant cancers worldwide. Despite obvious improvements in treatment, patients with HCC still have shorter survival time compared with other cancers. Because quite a large proportion of patients miss the opportunity to receive curative therapies, such as surgical removal, liver transplantation, or radiofrequency ablation (RFA), due to the fact that patients with HCC have no symptoms in its early stages and are discovered late at an initial diagnosis [5, 6]. Multiple studies have reported that tissue or serum osteoprotegerin (OPG) level is a prognostic factor for patients with cancer. Little is known about the role of serum OPG in hepatocellular carcinoma (HCC). We aimed to investigate whether serum OPG concentration has an effect on HCC patients’ prognosis
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