Journal of Gastrointestinal Surgery

, Volume 23, Issue 5, pp 922–932 | Cite as

A Novel Score Predicts HBV-Related Hepatocellular Carcinoma Recurrence After Hepatectomy: a Retrospective Multicenter Study

  • Wei QinEmail author
  • Li Wang
  • Beiyuan Hu
  • Shusheng Leng
  • Huan Tian
  • Huanxian Luo
  • Jia Yao
  • Xiaolong Chen
  • Chao Wu
  • Guihua ChenEmail author
  • Yang YangEmail author
Original Article



In China, hepatitis B virus (HBV) is an important causative factor of hepatocellular carcinoma (HCC). The contribution and interaction of fibrosis-4 (FIB-4) score and total tumor volume (TTV) in association with HCC recurrence is unknown. A reliable point score based on the FIB-4 score, TTV, and differentiation grade was established to predict the postoperative recurrence of HBV-related HCC patients who underwent hepatic resection (HR).


Three hundred thirty-eight HBV-related HCC patients from three institutions treated by HR were enrolled in this retrospective study. Prognostic factors were also evaluated by univariate and multivariate analysis using Cox’s proportional hazards model in the training cohort. The DFT score was established by a Cox regression model and validated in the internal cohort and the external cohorts from the other two institutions.


The DFT score differentiated four groups of HBV-related HCC patients (0, 1–2, 3, 4–5 points) with distinct prognosis (median recurrence-free survival (RFS), 72.7 vs. 53.0 vs. 23.2 vs. 5.7 months; P < 0.05). Its predictive accuracy as determined by the area under the receiver operating characteristic curve (AUC) at 1, 3, and 5 years (AUCs 0.7319, 0.7031, and 0.6972) was greater than the other three staging systems for HCC. These findings were supported by the validation cohorts.


The DFT model is a reliable and objective model to predict the RFS of HBV-related HCC patients after HR.


Hepatocellular carcinoma Hepatic resection Recurrence-free survival Total tumor volume FIB-4 


Financial Support

This work was supported by the grants from the Project funded by China Postdoctoral Science Foundation (2017M611459), National Natural Science Foundation of China (No. 81370575, 81570593), Sci-tech Research Development Program of Guangzhou city (No. 1581000156, 201400000001-3), and Sun Yat-sen University Clinical Research 5010 Program (2014006).

Authors’ Contributions

Conception and design: Wei Qin, Guihua Chen, Yang Yang

Acquisition of data: Li Wang, Beiyuan Hu, Shusheng Leng, Huanxian Luo

Analysis and interpretation of data: Huan Tian, Jia Yao, Chao Wu

Writing, review, and/or revision of the manuscript: Wei Qin, Xiaolong Chen, Yang Yang

Compliance with Ethical Standards

This study was approved by the Ethics Committee of The Third Affiliated Hospital of Sun Yat-Sen University, Huashan Hospital, Fudan University, The Affiliated Hospital/Clinical Medical College of Chengdu University, and conducted in accordance with the Declaration of Helsinki. A written informed consent was obtained from all the patients at the time of admission.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  1. 1.Department of General Surgery, Huashan Hospital, Cancer Metastasis InstituteFudan UniversityShanghaiChina
  2. 2.Department of Hepatic SurgeryThe Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  3. 3.Department of General SurgeryThe Affiliated Hospital/Clinical Medical College of Chengdu UniversityChengduChina
  4. 4.Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina
  5. 5.Guangdong Provincial Key Laboratory of Liver Disease ResearchGuangzhouChina

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