Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Nov;31(11):798-808.
doi: 10.1002/jhbp.12070. Epub 2024 Sep 23.

Evaluation of prognostic efficacy of liver immune status index in predicting postoperative outcomes in hepatocellular carcinoma patients: A multi-institutional retrospective study

Yuki Imaoka  1   2 , Masahiro Ohira  1   3 , Tsuyoshi Kobayashi  1 , Naruhiko Honmyo  1   4 , Michinori Hamaoka  5 , Takashi Onoe  6 , Daisuke Takei  7 , Koichi Oishi  8 , Tomoyuki Abe  9 , Toshihiro Nakayama  2 , Miho Akabane  2 , Kazunari Sasaki  2 , Hideki Ohdan  1 ; Hiroshima Surgical Study Group of Clinical Oncology (HiSCO)
Affiliations
Multicenter Study

Evaluation of prognostic efficacy of liver immune status index in predicting postoperative outcomes in hepatocellular carcinoma patients: A multi-institutional retrospective study

Yuki Imaoka et al. J Hepatobiliary Pancreat Sci. 2024 Nov.

Abstract

Background: Hepatocellular carcinoma (HCC) ranks third in cancer-related deaths globally. Despite treatment advances, high post-hepatectomy recurrence rates (RR), especially with liver fibrosis and hepatitis C virus infection, remain challenging. Key prognostic factors include vascular invasion and perioperative blood loss, impacting extrahepatic recurrence. Natural killer (NK) cells are crucial in countering circulating tumor cells through TRAIL-mediated pathways. The aim of this study was to validate the liver immune status index (LISI) as a predictive tool for liver NK cell antitumor efficiency, particularly in HCC patients with vascular invasion.

Methods: A retrospective analysis of 1337 primary HCC hepatectomies was conducted by the Hiroshima Surgical Study Group of Clinical Oncology (HiSCO). Clinicodemographic data were extracted from electronic medical records. Prognostic indices (FIB-4, ALBI, ALICE, GNRI, APRI, and LISI) were evaluated using area under the receiver operating characteristic curve values. Survival analyses employed Kaplan-Meier estimations and log-rank tests.

Results: LISI significantly correlated with other prognostic markers and stratified patients into risk groups with distinct overall survival (OS) and RR. It showed superior predictive performance for 2-year OS and RR, especially in patients with vascular invasion. Over longer periods, APRI and FIB-4 index reliabilities improved. The HISCO-HCC score, combining LISI, tumor burden score, and alpha-fetoprotein levels, enhanced prognostic accuracy.

Conclusion: LISI outperformed existing models, particularly in HCC with vascular invasion. The HISCO-HCC score offers improved prognostic precision, guiding immunotherapeutic strategies and individualized patient care in HCC.

Keywords: antitumor activity; hepatectomy; hepatocellular carcinoma; natural killer cells.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
The outcomes according to the liver immune status index (LISI) grades. (a) The 5‐year overall survival (OS) in all cases. (b) The 5‐year recurrence rates (RR) in all cases. (c) The 5‐year OS in vascular invasion cases. (d) The 5‐year RR in vascular invasion cases.
FIGURE 2
FIGURE 2
The area under the receiving operating characteristic curve (AUROC) of markers for the outcomes. (a) The 2‐year overall survival (OS) in all cases. (b) The 2‐year OS in vascular invasion cases. (c) The 2‐year recurrence rates (RR) in all cases. (d) The 2‐year RR in vascular invasion cases. *p < .05.
FIGURE 3
FIGURE 3
The time‐dependent area under the receiving operating characteristic curve (AUROC) analysis using the liver immune status index (LISI). (a) The 5‐year overall survival (OS) in vascular invasion cases. (b) The 5‐year RR in vascular invasion cases.
FIGURE 4
FIGURE 4
The time‐dependent area under the receiving operating characteristic curve (AUROC) analysis in the validation set. (a) The 5‐year overall survival (OS) in vascular invasion cases. (b) The 5‐year recurrence rates (RR) in vascular invasion cases. (c) The 5‐year OS in all cases. (d) The 5‐year RR in all cases.
FIGURE 5
FIGURE 5
HISCO‐HCC score.
See this image and copyright information in PMC

References

    1. McGlynn KA, Petrick JL, El‐Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology. 2021;73(Suppl 1):4–13. - PMC - PubMed
    1. Ko S, Kanehiro H, Hisanaga M, Nagao M, Ikeda N, Nakajima Y. Liver fibrosis increases the risk of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma. Br J Surg. 2002;89:57–62. - PubMed
    1. Hashimoto M, Kobayashi T, Ishiyama K, Ide K, Ohira M, Tahara H, et al. Predictive independent factors for extrahepatic metastasis of hepatocellular carcinoma following curative hepatectomy. Anticancer Res. 2017;37:2625–2631. - PubMed
    1. Taketomi A, Toshima T, Kitagawa D, Motomura T, Takeishi K, Mano Y, et al. Predictors of extrahepatic recurrence after curative hepatectomy for hepatocellular carcinoma. Ann Surg Oncol. 2010;17:2740–2746. - PubMed
    1. Kobayashi A, Kaido T, Hamaguchi Y, Okumura S, Taura K, Hatano E, et al. Impact of postoperative changes in sarcopenic factors on outcomes after hepatectomy for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci. 2016;23:57–64. - PubMed

Publication types