Evaluation of prognostic factors on recurrence after curative resections for hepatocellular carcinoma

Table 1 Patients’ characteristics n (%)

Total	Patients (n = 298)
Age (yr)	56.4 ± 9.7
Sex (male)	232 (77.9)
Disease
Hepatitis B	213 (71.5)
Hepatitis C	18 (6.0)
Alcohol	16 (5.4)
Others	51 (17.1)
PLT (× 103/μL)	151.93 ± 70.11 (36.0-417.0)
Total bilirubin (mg/dL)	1.17 ± 5.97 (0.11-7.88)
ICG at 15 min (%)	11.64 ± 13.95
CTP score	5.40 ± 0.72
MELD score	6.36 ± 2.93
AFP (ng/mL)	1459.90 ± 10124.9
	19.50 (4.30-268.31)1
PIVKA II (mAU/mL)	499.1 ± 1434.7
	44.50 (21.00-255.00)1
Tumor number	1.27 ± 0.85
Tumor size (cm)	4.49 ± 3.12

¹Data are shown as median (interquartile range). PLT: Platelet; ICG: Indocyanine green; CTP: Child-Turcotte-Pugh; MELD: Model for End-stage Liver Disease; AFP: Alpha fetoprotein; PIVKA II: Protein induced by vitamin K absence or angiotensin-II.

Table 2 Preoperative prediction factors for tumor biology n (%)

Variables	Low grade (I, II)(n = 134)	High grade (III, IV)(n = 105)	P value	Multivariate
				Relative risk	P value
Tumor size (cm)	3.83 ± 2.35	5.46 ± 3.75	< 0.001
> 5 (n = 59)	22 (16.4)	37 (35.2)	0.003	1.695 (0.594–4.836)	0.324
AFP (ng/mL)	254.4 ± 771.0	3644.9 ± 16856.5	0.023
> 100 (n = 91)	37 (27.6)	54 (51.4)	< 0.001	2.897 (1.080-7.775)	0.035
PIVKA II (mAU/mL)	214.2 ± 355.6	1079.1 ± 2248.3	0.001
> 300 (n = 36)	17 (12.7)	19 (18.1)	0.173	1.000 (1.000-1.001)	0.303
SUVs on PET	3.80 ± 2.21	5.83 ± 3.93	0.004
> 3.5 (n = 44)	15 (11.2)	29 (27.6)	< 0.001	3.305 (1.214-8.996)	0.019
RER on MRI	0.80 ± 0.14	0.68 ± 0.12	< 0.001
< 0.6 (n = 11)	1 (0.7)	10 (9.5)	0.001	1.888 (1.094–3.588)	0.050

AFP: Alpha fetoprotein; PIVKA II: Protein induced by vitamin K absence or angiotensin-II; SUVs: Standardized uptake values; PET: Positron emission tomography; RER: Relative enhancement ratio; MRI: Magnetic resonance imaging.

Table 3 Preoperative risk factors for recurrence n (%)

Variables	Non recurrence(n = 169)	Recurrence(n = 129)	P value	Multivariate
				Relative risk	P value
Age (yr)	56.4 ± 9.6	56.2 ± 9.9	0.717
Gender (male)	123 (72.8)	109 (84.5)	0.026	2.192 (1.060–4.532)	0.034
Cause of HCC (HBV:HCV:Alcohol:Others)	116:11:8:34	97:7:8:17	0.402
PLT (× 103/μL)	155.07 ± 80.10	149.53 ± 61.57	0.500
Bilirubin (mg/dL)	1.38 ± 7.88	0.90 ± 0.97	0.491
ICG	12.54 ± 16.83	10.43 ± 8.68	0.271
CTP scores	5.37 ± 0.72	5.44 ± 0.71	0.409
MELD scores	6.26 ± 3.03	6.48 ± 2.79	0.521
AFP (ng/mL)	868.10 ± 4358.4	2212.3 ± 14588.5	0.264
> 100 (n = 101)	48 (28.4)	53 (41.1)	0.004	1.888 (1.094–3.588)	0.050
PIVKA II (mAU/mL)	327.4 ± 886.0	795.1 ± 2040.9	0.048
> 100 (n = 55)	32 (18.9)	23 (17.8)	0.466
Tumor size (cm)	3.84 ± 2.66	5.28 ± 3.46	< 0.001
> 5 (n = 72)	27 (16.0)	45 (34.9)	< 0.001	1.516 (0.797–2.882)	0.204
Tumor number	1.18 ± 0.57	1.39 ± 1.10	0.046
Multiple (n = 40)	19 (11.2)	21 (16.2)	0.124
SUVs on PET CT	3.84 ± 1.80	5.94 ± 4.20	0.001
> 3.5 (n = 47)	22 (13.0)	25 (19.4)	0.005	2.025 (1.046–3.921)	0.036
RER (n = 100)	0.75 ± 0.16	0.72 ± 0.12	0.295
< 0.6 (n = 11)	4 (2.4)	7 (5.4)	0.011

HCC: Hepatocellular carcinoma; HBV: Hepatitis B virus; HCV: Hepatitis C virus; PLT: Platelets; ICG: Indocyanine green; CTP: Child-Turcotte-Pugh; MELD: Model for End-stage Liver Disease; AFP: Alpha fetoprotein; PIVKA II: Protein induced by vitamin K absence or angiotensin-II; SUVs: Standardized uptake values; PET: Positron emission tomography; RER: Relative enhancement ratio.

Table 4 Preoperative factors associated with survival n (%)

Variable	Survival(n = 202)	Death(n = 96)	P value	Multivariate
				Relative risk	P value
Age (yr)	57.0 ± 9.6	55.2 ± 9.8	0.131
Gender (male)	150 (74.3)	82 (85.4)	0.102
Cause of HCC (HBV:HCV:Alcohol:Others)	143:14:9:36	70:4:7:15	0.568
PLT (× 103/μL)	151.84 ± 62.56	152.11 ± 84.19	0.975
Bilirubin (mg/dL)	1.24 ± 7.21	1.04 ± 1.15	0.783
ICG	12.05 ± 15.45	10.61 ± 9.21	0.496
CTP scores	5.31 ± 0.63	5.59 ± 0.84	0.003	1.682 (0.310-9.116)	0.066
MELD scores	6.08 ± 2.51	6.93 ± 3.76	0.020	5.413 (0.895-32.718)	0.547
AFP (ng/mL)	667.2 ± 3733.2	3086.7 ± 16970.2	0.057
> 100 (n = 101)	58 (28.7)	43 (44.8)	0.005	3.061 (1.183-7.922)	0.021
PIVKA II (mAU/mL)	399.6 ± 1200.3	941.6 ± 2169.4	0.066
> 100 (n = 55)	42 (20.8)	13 (13.5)	0.159
Tumor size (cm)	4.08 ± 2.86	5.30 ± 3.47	0.002
> 5 (n = 72)	36 (17.8)	36 (37.5)	< 0.001	1.796 (0.705-4.574)	0.220
Tumor number	1.17 ± 0.59	1.48 ± 1.19	0.005
multiple (n = 40)	20 (9.9)	20 (20.8)	0.010	2.475 (0.505-12.137)	0.264
SUVs on PET CT	4.09 ± 2.45	6.57 ± 4.35	0.001
> 3.5 (n = 47)	28 (13.9)	19 (19.8)	< 0.001	7.331 (2.182-24.630)	0.001
RER (n = 100)	0.75 ± 0.15	0.70 ± 0.13	0.295
< 0.6 (n = 11)	7 (3.5)	4 (4.2)	0.003

HCC: Hepatocellular carcinoma; HBV: Hepatitis B virus; HCV: Hepatitis C virus; PLT: Platelets; ICG: Indocyanine green; CTP: Child-Turcotte-Pugh; MELD: Model for End-stage Liver Disease; AFP: Alpha fetoprotein; PIVKA II: Protein induced by vitamin K absence or angiotensin-II; SUVs: Standardized uptake values; PET: Positron emission tomography; RER: Relative enhancement ratio.