A Novel Score Predicts HBV-Related Hepatocellular Carcinoma Recurrence After Hepatectomy: a Retrospective Multicenter Study

Abstract

Background: In China, hepatitis B virus (HBV) is an important causative factor of hepatocellular carcinoma (HCC). The contribution and interaction of fibrosis-4 (FIB-4) score and total tumor volume (TTV) in association with HCC recurrence is unknown. A reliable point score based on the FIB-4 score, TTV, and differentiation grade was established to predict the postoperative recurrence of HBV-related HCC patients who underwent hepatic resection (HR).

Methods: Three hundred thirty-eight HBV-related HCC patients from three institutions treated by HR were enrolled in this retrospective study. Prognostic factors were also evaluated by univariate and multivariate analysis using Cox's proportional hazards model in the training cohort. The DFT score was established by a Cox regression model and validated in the internal cohort and the external cohorts from the other two institutions.

Results: The DFT score differentiated four groups of HBV-related HCC patients (0, 1-2, 3, 4-5 points) with distinct prognosis (median recurrence-free survival (RFS), 72.7 vs. 53.0 vs. 23.2 vs. 5.7 months; P < 0.05). Its predictive accuracy as determined by the area under the receiver operating characteristic curve (AUC) at 1, 3, and 5 years (AUCs 0.7319, 0.7031, and 0.6972) was greater than the other three staging systems for HCC. These findings were supported by the validation cohorts.

Conclusions: The DFT model is a reliable and objective model to predict the RFS of HBV-related HCC patients after HR.

Keywords: FIB-4; Hepatic resection; Hepatocellular carcinoma; Recurrence-free survival; Total tumor volume.