Significance of platelet count and platelet-based models for hepatocellular carcinoma recurrence

Figure 1 Predictive potentials for detecting recurrence. Receiver operating characteristic (ROC) curves for Cancer of the Liver Italian Program (CLIP) and platelet count/age/alkaline phosphatase/alpha-fetoprotein/aspartate aminotransferase (PAPAS) indices and platelet count (PLT).

Figure 2 Survival and recurrence. Kaplan-Meier curves for cumulative recurrence (A) and overall survival (B). Boxplots comparing platelet count with recurrence (C) and overall survival (D).

Figure 3 Cumulative recurrence. Kaplan-Meier curves of patients stratified according to A: Platelet count (PLT); B: Aspartate aminotransferase/platelet count ratio (APRI) index; C: Fibrosis index based on the four factors (FIB-4); D: Fibro-quotient (FibroQ); E: Aspartate aminotransferase/platelet count/γ-glutamyl transpeptidase/alpha-fetoprotein (APGA) index; F: Platelet count/age/alkaline phosphatase/alpha-fetoprotein/aspartate aminotransferase (PAPAS) index.

Figure 4 Multivariate analysis of prognostic indicators expressed as binary variables. A: Clinical and biochemical parameters; B: Noninvasive indices. AAR: Aspartate aminotransferase/alanine aminotransferase ratio; AFP: Alpha-fetoprotein; ALP: Alkaline phosphatase; APGA: Aspartate aminotransferase/platelet count/γ-glutamyl transpeptidase/alpha-fetoprotein index; APRI: Aspartate aminotransferase/platelet count ratio index; AST: Aspartate aminotransferase; CLIP: Cancer of the Liver Italian Program; FIB-4: Fibrosis index based on the four factors; FibroQ: Fibro-quotient; GGT: γ-glutamyl transpeptidase; HR: Hazard ratio; PAPAS: Platelet count/age/alkaline phosphatase/alpha- fetoprotein/aspartate aminotransferase index; PLT: Platelet count.

Figure 5 Multivariate analysis of noninvasive indices expressed as continuous variables. AAR: Aspartate aminotransferase/alanine aminotransferase ratio; APGA: Aspartate aminotransferase/platelet count/γ-glutamyl transpeptidase/alpha- fetoprotein index; APRI: Aspartate aminotransferase/platelet count ratio index; CLIP: Cancer of the Liver Italian Program; FIB-4: Fibrosis index based on the four factors; FibroQ: Fibro-quotient; HR: Hazard ratio; PAPAS: Platelet count/age/alkaline phosphatase/alpha-fetoprotein/aspartate aminotransferase index.

Figure 6 Predictors of early and late recurrences by multivariate analysis. AAR: Aspartate aminotransferase/alanine aminotransferase ratio; AFP: Alpha-fetoprotein; ALP: Alkaline phosphatase; APGA: Aspartate aminotransferase/platelet count/γ-glutamyl transpeptidase/AFP index; AST: Aspartate aminotransferase; CLIP: Cancer of the Liver Italian Program; GGT: γ-glutamyl transpeptidase; HBV: Hepatitis B virus; HR: Hazard ratio; PAPAS: Platelet count/age/alkaline phosphatase/alpha-fetoprotein/aspartate aminotransferase index; PLT: Platelet count.

Figure 7 Cumulative recurrence curves of cirrhotic and non-cirrhotic patients. Kaplan-Meier curves of patients stratified according to A, B: Platelet count (PLT); C, D: Aspartate aminotransferase/PLT/γ-glutamyl transpeptidase/alpha-fetoprotein (APGA) index; E, F: PLT/age/alkaline phosphatase/alpha-fetoprotein/aspartate aminotransferase (PAPAS) index.

Figure 8 Cumulative recurrence curves of patients with large (≥ 5 cm) and small (< 5 cm) tumors. Kaplan-Meier curves of patients stratified according to A, B: Platelet count (PLT); C, D: Aspartate aminotransferase/PLT/γ-glutamyl transpeptidase/alpha-fetoprotein (APGA) index; E, F: PLT/age/alkaline phosphatase/alpha- fetoprotein/aspartate aminotransferase (PAPAS) index.