Open AccessVerification of inflammation‐based prognostic marker as a prognostic indicator in hepatocellular carcinoma
Author(s) -
Yamamoto Masateru,
Kobayashi Tsuyoshi,
Kuroda Shintaro,
Hamaoka Michinori,
Okimoto Sho,
Honmyo Naruhiko,
Yamaguchi Megumi,
Ohdan Hideki
Publication year - 2019
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12286
Subject(s) - medicine , hazard ratio , hepatocellular carcinoma , proportional hazards model , oncology , c reactive protein , inflammation , univariate analysis , multivariate analysis , propensity score matching , neutrophil to lymphocyte ratio , gastroenterology , hepatectomy , confidence interval , lymphocyte , surgery , resection
Aim Although inflammation‐based markers in cancer have been used for prognostic prediction, the most useful marker for hepatocellular carcinoma ( HCC ) has not been established. We investigated the usefulness of various inflammation‐based markers in HCC patients after hepatectomy. Methods A total of 478 patients who underwent initial hepatectomy for HCC from 2009 to 2015 and were diagnosed with pathological HCC were included in this retrospective study. Inflammation‐based markers consisted of the C‐reactive protein to albumin ratio ( CAR ), Glasgow prognostic score ( GPS ), neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio, platelet to lymphocyte ratio and prognostic index. Univariate and multivariate analyses for overall survival ( OS ) and disease‐free survival ( DFS ) using the Cox proportional hazard model were carried out. Kaplan‐Meier analysis and log‐rank test were used for comparison of OS and DFS . To reduce influences of selection bias and confounders for stratifying CAR , clinicopathological characteristics of patients were balanced by propensity score matching. Results Multivariate analysis identified only high CAR (>0.027) as an indicator of poor OS , and high CAR and high GPS (1‐2) as indicators of poor DFS among inflammation‐based markers. After propensity score matching, 124 patients each with low CAR and high CAR were matched. High CAR was correlated with both poor OS and DFS . Conclusion C‐reactive protein to albumin ratio was the most valuable prognostic indicator after hepatectomy for HCC among inflammation‐based markers.