Fibrosis-4 index, a predictor for prognosis of hepatocellular carcinoma patients after curative hepatectomy even in hepatitis B virus dominant populations

Sang Oh Yun; Jong Man Kim; Jinsoo Rhu; Gyu-Seong Choi; Jae-Won Joh

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저자정보: Sang Oh Yun (Sungkyunkwan University School of Medicine) Jong Man Kim (Sungkyunkwan University School of Medicine) Jinsoo Rhu (Sungkyunkwan University School of Medicine) Gyu-Seong Choi (Sungkyunkwan University School of Medicine) Jae-Won Joh (Sungkyunkwan University School of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.104 No.4

발행연도: 2023.4

수록면: 195 - 204 (10page)

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Purpose: Liver fibrosis plays an important role in the development of hepatocellular carcinoma (HCC) and determining its prognosis. Although many staging systems and liver reserve models have been developed without the intention of predicting prognosis of HCC, some studies have investigated their prognostic values in HCC after curative liver resection (LR). The aim of this study is to evaluate prognostic value of non-invasive biomarkers after curative LR.
Methods: Between 2006 and 2013, HCC patients underwent LR were included and total 962 patients were enrolled. All non-invasive biomarkers (fibrosis 4 index (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), AAR-to-platelet ratio index (AARPRI), and albumin-bilirubin (ALBI) score) were measured at the time of HCC diagnosis. To binarize each biomarker, an optimal cut-off value for fibrosis stage was selected using the value of minimum distance from the left-upper corner of the receiver operating characteristic curve with a specificity >60%. We performed Cox regression analysis on 2-year recurrence-free survival (RFS) and overall survival (OS).
Results: The area under curve values for FIB-4 and APRI were the largest for fibrosis stage compared to other biomarkers, 0.669 (95% confidential interval (CI), 0.610–0.719) and 0.748 (95% CI, 0.692–0.800), respectively. Between those two indices, FIB-4 is considered a statistically significant prognostic factor of RFS in HCC patients after LR. The HR for 2-year RFS and OS were 1.81 (95% CI, 1.18–2.77; P = 0.007) and 2.36 (95% CI, 0.99–5.65; P = 0.054), respectively.
Conclusion: FIB-4 is identified as a statistically significant predictor of HCC prognosis after curative LR even in HBV dominant populations.

#Aspartate aminotransferase-to-platelet ratio index #Fibrosis-4 index #Hepatectomy #Hepatocellular carcinoma #Liver cirrhosis

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