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Combined Preoperative ALBI and FIB-4 Is Associated with Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background and Purpose

Chronic inflammatory response is a risk factor for hepatocarcinogenesis and recurrence. This study aimed to develop a nomogram incorporating the combined albumin-bilirubin (ALBI) and fibrosis-4 (FIB-4) scores and the peritumoral inflammation score (PIS) to predict postoperative recurrence-free survival (RFS) of hepatocellular carcinoma (HCC).

Methods

The prognostic roles of preoperative ALBI and FIB-4 scores for HCC recurrence were investigated, and a nomogram was developed. The predictive ability of the nomogram was compared with the American Joint Commission on Cancer (AJCC) and Barcelona Clinic Liver Cancer (BCLC) staging systems for HCC. Necroinflammatory activity in the peritumoral liver tissues was evaluated by hematoxylin and eosin (H&E) staining.

Results

Combined ALBI and FIB-4 was associated with PIS in the training and validation cohorts (r = 0.342 and 0.473, both P < 0.001), and all of the scores exhibited predictive value for RFS of HCC. The independent predictive factors of RFS such as AFP, tumor number, tumor size, microvascular invasion, PIS, and combined ALBI and FIB-4 were included in the corresponding nomogram. In the training cohort, the C-index of the RFS nomogram was 0.722. ROC analyses showed that the RFS nomogram had a larger AUC (0.739) than the AJCC and BCLC staging systems. These results were verified by the validation cohort.

Conclusions

The proposed nomogram incorporating PIS and combined ALBI and FIB-4 was associated with recurrence for HCC following curative hepatectomy.

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Acknowledgements

This research was supported by National Key Clinical Specialist Construction Programs of China (No. 2012-649); National Natural Science Foundation of China (No. 81301656), and Key Basic and Advanced Research Project of Science and Technology Commission of Chongqing Municipality (No. cstc2017jcyjBX0010).

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Chongqing, 400016, China

    Rui Liao, De-Wei Li, Cheng-You Du & Ming Li

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  1. Rui Liao
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  2. De-Wei Li
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  3. Cheng-You Du
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  4. Ming Li
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Contributions

Rui Liao did the conceptualization, formal analysis, funding acquisition, and writing-original draft. De-Wei Li did the data analysis and data collection. Cheng-You Du and Ming Li did the data analysis, project administration, funding acquisition, writing-review, and editing.

Corresponding author

Correspondence to Cheng-You Du.

Electronic supplementary material

Table S1

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Table S2

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Table S3

(DOC 15 kb)

Figure S1

Kaplan-Meier survival curves of recurrence-free survival (RFS) of ALBI (A and B) and FIB-4 (C and D) in the training cohort (A and C) and the validation cohorts (B and D), respectively. (GIF 21 kb)

High resolution image (TIF 3567 kb)

Figure S2

Kaplan-Meier survival curves of recurrence-free survival (RFS) of AJCC (A and B) and BCLC (C and D) in the training cohort (A and C) and the validation cohorts (B and D), respectively. (GIF 22 kb)

High resolution image (TIF 3324 kb)

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Liao, R., Li, DW., Du, CY. et al. Combined Preoperative ALBI and FIB-4 Is Associated with Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy. J Gastrointest Surg 22, 1679–1687 (2018). https://doi.org/10.1007/s11605-018-3810-1

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  • DOI: https://doi.org/10.1007/s11605-018-3810-1

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