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Clinical significance of preoperative inflammation-based score for the prognosis of patients with hepatocellular carcinoma who underwent hepatectomy

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Abstract

Purposes

The present study investigated the prognostic value of inflammation-based prognostic scores in patients with hepatocellular carcinoma (HCC) who underwent hepatectomy.

Methods

In total, 493 patients diagnosed HCC using the Milan criteria who underwent hepatic resection were retrospectively analyzed. Patients were evaluated according to several prognostic nutrition indices. Univariate and multivariate analyses were performed to identify clinicopathological variables associated with the overall survival (OS).

Results

According to a univariate analysis, higher values in the Glasgow Prognostic Score [GPS] (hazard ratio [HR] = 1.99, p = 0.002), modified GPS [mGPS] (HR = 2.26, p < 0.001), C-reactive protein [CRP]-to-albumin ratio [CAR] (HR = 1.86, p = 0.0012), and CONUT (HR = 1.65, p = 0.008) and a lower value of prognostic nutritional index [PNI] (HR = 2.36, p < 0.001) were significantly associated with a poor OS. A multivariate analysis showed that a CAR ≥ 0.037 (HR = 1.67, 95% CI 1.06–2.64, p = 0.03), FIB4-index > 3.25 (HR = 1.98, 95% confidence interval [CI] 1.25–3.14, p = 0.004) and PIVKA-II > 40 mAU/ml (HR = 1.72, 95% CI 1.14–2.61, p = 0.01) were independent prognostic factors.

Conclusions

This study demonstrated that the CAR was an independent prognostic score in patients with HCC and superior to other inflammation-based prognostic scores in terms of the prognosis.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Takashi Matsumoto, Yuki Kitano, Katsunori Imai, Shotaro Kinoshita, Hiroki Sato, Yuta Shiraishi, Kosuke Mima, Hiromitsu Hayashi, Yo-ichi Yamashita & Hideo Baba

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  1. Takashi Matsumoto
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  2. Yuki Kitano
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  3. Katsunori Imai
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  4. Shotaro Kinoshita
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  5. Hiroki Sato
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Correspondence to Hideo Baba.

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Matsumoto, T., Kitano, Y., Imai, K. et al. Clinical significance of preoperative inflammation-based score for the prognosis of patients with hepatocellular carcinoma who underwent hepatectomy. Surg Today 52, 1008–1015 (2022). https://doi.org/10.1007/s00595-021-02427-x

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