The ratio of serum des-gamma-carboxy prothrombin to tumor volume as a new biomarker for early recurrence of resected hepatocellular carcinoma.

Abstract

Early recurrence (ER) of hepatocellular carcinoma (HCC) (within 1year after resection) is known to be a poor prognostic factor. The aim was to identify the risk factors associated with ER after HCC resection. Data were analyzed retrospectively from patients who underwent primary resection for HCC from two hospitals. For cross-validation, HCC resection cases were divided into the training and testing cohort. The clinicopathological factors between the ER and non-ER groups and factors for predicting ER and prognosis after HCC resection were compared. Out of 173 patients in the training dataset, 33 patients had ER and the ERgroup showed larger tumor size, more intrahepatic metastasis (IM), and a higherratio of serum des-gamma-carboxy prothrombin (DCP) to tumor volume (TV) (DCP/TV) than the non-ER group. Out of 203 patients in the testing dataset, 30 patients had ER and the ER group demonstrated larger tumor size, more IM, and higher serum alpha-fetoprotein, AFP/TV, DCP/TV, AFP/tumor maximum diameter (TMD), and DCP/TMD than the non-ER group. The patients were divided into high and low DCP/TV groups and high serum DCP/TV was associated with unfavorable overall survival in the training and testing dataset. Multivariate analysis confirmed that high serum DCP/TV and IM were independently associated with ER. Preoperative high serum DCP/TV may be useful for stratifying patients at risk of early HCC recurrence after curative resection.