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FIB-4 index for assessing the prognosis of hepatocellular carcinoma in patients with Child-Pugh class A liver function

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

We evaluated the prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh (C-P) class A based on FIB-4 index, which is a liver fibrosis marker.

Patients and methods

A total of 915 HCC patients with C-P class A were investigated. We assessed the prognosis using FIB-4 index, and factors associated with survival rates were analyzed in these patients.

Results

When patients were categorized according to FIB-4 index as <2.0 (n = 93), ≥2.0 and <4.0 (n = 311), and ≥4.0 (n = 511), survival rates at 5 years were 70.5 % [95 % confidence interval (CI) 59.0–79.9], 56.4 % (95 % CI 50.1–62.5), and 47.1 % (95 % CI 42.2–52.1), respectively. Patients with FIB-4 index <2.0 had a higher survival rate than the other groups (≥4.0 vs ≥2.0 and <4.0, p = 0.010; ≥2.0 and <4.0 vs <2.0, p = 0.028). We were able to predict prognosis in patients with C-P score 5 by FIB-4 index, but survival rate did not significantly differ in patients with C-P score 6. Multivariate analysis identified C-P score, FIB-4 index [≥2.0 and <4.0; hazard ratios (HRs) 1.638 (95 % CI 1.084–2.474); p = 0.019/≥4.0; HR 1.828 (95 % CI 1.217–2.744); p = 0.004], Lens culinaris agglutinin-reactive α-fetoprotein, tumor size, number, vascular invasion, antiviral therapy, and hepatectomy as independent predictive factors for survival.

Conclusions

The FIB-4 index is useful for assessing prognosis in HCC patients with C-P class A, especially those with C-P score 5.

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Abbreviations

HCC:

Hepatocellular carcinoma

C-P:

Child-Pugh

SVR:

Sustained virological response

HCV:

Hepatitis C virus

HBV:

Hepatitis B virus

EASL:

European Association for the Study of the Liver

AFP:

α-Fetoprotein

AFP-L3:

Lens culinaris agglutinin-reactive α-fetoprotein

DCP:

Des-γ-carboxy prothrombin

US:

Ultrasonography

CT:

Computed tomography

MRI:

Magnetic resonance imaging

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

HR:

Hazard ratio

LAT:

Locoregional ablative therapy

RFA:

Radiofrequency ablation

TACE:

Transcatheter arterial chemoembolization

CI:

Confidence interval

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Acknowledgments

There is no grant or other financial support for this study.

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The authors declare no conflicts of interests.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, 4-86, Minaminokawa-cho, Ogaki, Gifu, 503-8052, Japan

    Takanori Ito, Takashi Kumada, Hidenori Toyoda & Toshifumi Tada

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  1. Takanori Ito
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  2. Takashi Kumada
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  3. Hidenori Toyoda
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  4. Toshifumi Tada
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Correspondence to Takanori Ito.

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Ito, T., Kumada, T., Toyoda, H. et al. FIB-4 index for assessing the prognosis of hepatocellular carcinoma in patients with Child-Pugh class A liver function. J Cancer Res Clin Oncol 141, 1311–1319 (2015). https://doi.org/10.1007/s00432-015-1922-5

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  • DOI: https://doi.org/10.1007/s00432-015-1922-5

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