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The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection

  • Hepatobiliary Tumors
  • Published:
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Abstract

Background

Nutritional status assessment is essential in cancer patients because a poor nutritional status has been associated with poor outcomes; however, the impact of rapid turnover proteins (RTPs), such as prealbumin, transferrin, and retinol-binding protein, on the outcomes of hepatocellular carcinoma (HCC) has not been well-investigated. We therefore examined the prognostic significance of RTPs in patients with HCC after curative resection.

Methods

This study included 150 patients who underwent elective hepatic resection for HCC between January 2011 and December 2018. The prealbumin, transferrin, and retinol-binding protein levels were classified into two groups (high vs. low); the RTP score (0–3) was calculated as the sum of each RTP measurement (high = 0; low = 1). We retrospectively investigated the relationship between the RTP score and disease-free and overall survival.

Results

Multivariate analysis showed that a high RTP score (P = 0.022), presence of sarcopenia (P = 0.001), and stage III or higher (P = 0.005) were independent predictors of disease-free survival, while a high RTP score (P < 0.001), presence of sarcopenia (P = 0.017), and stage III or higher (P = 0.012) were independent predictors of overall survival. In patients with high RTP scores, positive hepatitis B and C viral infection, high indocyanine green (ICG) at 15 min (ICGR15), Child–Pugh grade B, poorly differentiated carcinoma, and postoperative ascites were more common than in patients with low RTP scores.

Conclusion

The preoperative RTP score may be a prognostic factor in patients with hepatocellular carcinoma after hepatic resection, suggesting an important role of RTP in the assessment of nutritional status in cancer patients.

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Acknowledgments

This work was supported by JSPS KAKENHI grants JP21K08718 (to TI) and JP21K08805 (to KH) and by a research grant from the Uehara Memorial Foundation (to TI). The authors would like to thank Editage (www.editage.com) for English-language editing.

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan

    Mitsuru Yanagaki MD, Koichiro Haruki MD, PhD, Jungo Yasuda MD, PhD, Kenei Furukawa MD, PhD, Shinji Onda MD, PhD, Masashi Tsunematsu MD, Yoshihiro Shirai MD, PhD, Takeshi Gocho MD, PhD, Tomohiko Taniai MD, Ryoga Hamura MD & Toru Ikegami MD, PhD

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  1. Mitsuru Yanagaki MD
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  2. Koichiro Haruki MD, PhD
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  3. Jungo Yasuda MD, PhD
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  4. Kenei Furukawa MD, PhD
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  5. Shinji Onda MD, PhD
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  6. Masashi Tsunematsu MD
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  7. Yoshihiro Shirai MD, PhD
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  11. Toru Ikegami MD, PhD
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Corresponding author

Correspondence to Koichiro Haruki MD, PhD.

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Mitsuru Yanagaki, Koichiro Haruki, Jungo Yasuda, Kenei Furukawa, Shinji Onda, Masashi Tsunematsu, Yoshihiro Shirai, Takeshi Gocho, Tomohiko Taniai, Ryoga Hamura, and Toru Ikegami declare they have no conflicts of interest.

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Yanagaki, M., Haruki, K., Yasuda, J. et al. The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection. Ann Surg Oncol 28, 8130–8139 (2021). https://doi.org/10.1245/s10434-021-10704-9

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