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The preoperative globulin‐to‐albumin ratio, a novel inflammation‐based prognostic system, predicts survival after potentially curative liver resection for patients with hepatocellular carcinoma
Author(s) -
Shimizu Takayuki,
Ishizuka Mitsuru,
Suzuki Takashi,
Tanaka Genki,
Park Kyung Hwa,
Matsumoto Takatsugu,
Shiraki Takayuki,
Sakuraoka Yuhki,
Kato Masato,
Aoki Taku,
Kubota Keiichi
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24772
Subject(s) - medicine , hazard ratio , hepatocellular carcinoma , gastroenterology , proportional hazards model , univariate analysis , multivariate analysis , confidence interval , survival analysis , hepatectomy , log rank test , albumin , oncology , surgery , resection
Background and Objectives Although the globulin‐to‐albumin ratio (GAR) is useful for prognostication of patients with various cancers, its relationship with hepatocellular carcinoma (HCC) remains unclear. The study aims to investigate the relationship between GAR and postoperative survival among patients with HCC undergoing potentially curative liver resection (LR). Methods We retrospectively reviewed 368 patients with newly diagnosed HCC who underwent initial and potentially curative LR. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS). Kaplan‐Meier analysis and log‐rank test were used to compare OS and disease‐free survival (DFS). Results The result of multivariate analysis using 25 clinical characteristics selected by univariate analysis revealed that the GAR (≥0.918/<0.918) was significantly associated with OS (hazard ratio [HR], 2.398; 95% confidence interval [CI], 1.012‐5.683; P = 0.047), as well as platelet count (<14/≥14, ×10 4 /mm 3 ) and portal vein invasion (presence/absence). Kaplan‐Meier analysis and log‐rank test demonstrated that the OS and DFS of patients with a high GAR (>0.918) were significantly worse than that of patients with a low GAR (≤0.918). Conclusions The GAR is a useful predictor of postoperative survival among patients with HCC undergoing potentially curative LR.