Clinical Research Papers:
Metavir and FIB-4 scores are associated with patient prognosis after curative hepatectomy in hepatitis B virus-related hepatocellular carcinoma: a retrospective cohort study at two centers in China
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Abstract
Rui Liao1,*, Yi-Peng Fu2,*, Ting Wang1,*, Zhi-Gang Deng3,*, De-Wei Li1, Jia Fan2,4, Jian Zhou2,4, Gen-Sheng Feng5, Shuang-Jian Qiu2 and Cheng-You Du1
1 Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
2 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
3 Department of General Surgery, Mianyang Central Hospital, Mianyang, China
4 Institute of Biomedical Sciences, Fudan University, Shanghai, China
5 Department of Pathology and Division of Biological Sciences, University of California San Diego, La Jolla, California, USA
* These authors have contributed equally to this work
Correspondence to:
Shuang-Jian Qiu, email:
Cheng-You Du, email:
Keywords: liver cirrhosis; hepatitis B virus; cancer; surgery; prognosis
Received: April 23, 2016 Accepted: September 14, 2016 Published: September 20, 2016
Abstract
Although Metavir and Fibrosis-4 (FIB-4) scores are typically used to assess the severity of liver fibrosis, the relationship between these scores and patient outcome in hepatocellular carcinoma (HCC) is unclear. The aim of this study was to evaluate the prognostic value of the severity of hepatic fibrosis in HBV-related HCC patients after curative resection. We examined the prognostic roles of the Metavir and preoperative FIB-4 scores in 432 HBV-HCC patients who underwent curative resection at two different medical centers located in western (Chongqing) and eastern (Shanghai) China. In the testing set (n = 108), the Metavir, FIB-4, and combined Metavir/FIB-4 scores were predictive of overall survival (OS) and recurrence-free survival (RFS). Additionally, they were associated with several clinicopathologic variables. In the validation set (n = 324), the Metavir, FIB-4, and combined Metavir/FIB-4 scores were associated with poor prognosis in HCC patients after curative resection. Importantly, in the negative alpha-fetoprotein subgroup (≤ 20 ng/mL), the FIB-4 index (I vs. II) could discriminate between patient outcomes (high or low OS and RFS). Thus Metavir, preoperative FIB-4, and combined Metavir/FIB-4 scores are prognostic markers in HBV-HCC patients after curative hepatectomy.
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