Abstract
Purpose: The current clinical stage of hepatocellular carcinoma (HCC) is insufficient to predict the prognosis. Previous studies have shown that various preoperative inflammation indicators can predict the prognosis of HCC, but the role of postoperative inflammation indicators remains unclear. The purpose of this study was to explore the prognostic value of postoperative inflammation indicators and establish a clinical prognostic model combining preoperative and postoperative inflammation indicators. Methods: 88 patients with primary HCC from Beijing Tsinghua ChangGung Hospital in the National Hepatobiliary Standard Database were included in the study. Preoperative and postoperative prognostic models were established based on preoperative clinicopathological features and combined with postoperative inflammation indicators. The prognostic value of the four models was evaluated by the area under the curve of time-dependent receiver operating characteristic curves (td-AUC). Results: Multivariate analysis of preoperative clinicopathological indicators found that preoperative alpha-fetoprotein (AFP), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), Prognostic Nutritional Index (PNI), tumor number and microvascular invasion were independent prognostic factors for disease-free survival (DFS). Introducing the postoperative inflammatory indicators for multivariate analysis found that preoperative AFP, PLR, LMR, PNI and postoperative neutrophil-lymphocyte ratio (NLR) and PLR were independent prognostic factors for DFS and establish a postoperative model. The postoperative model had higher td-AUC values than the preoperative model, TNM stage, Barcelona Clinic Liver Cancer (BCLC) stage in 1-year (0.849 VS 0.826, 0.514 and 0.532), 2-year (0.809 VS 0.799, 0.513 and 0.527), and 3-year (0.784 VS 0.783, 0.509 and 0.529) after surgery. Conclusions: Postoperative inflammation indicators are valuable prognostic indicators, and the predictive performance of the combined model is better than preoperative stage, TNM stage and BCLC stage.
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