A prognostic score based on early recurrence-related factors for hepatocellular carcinoma patients with microvascular invasion after hepatectomy

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PURPOSE: We aimed to construct a simple risk score to stratify individuals with distinguished prognosis for HCC patients with microvascular invasion (MVI). METHODS: 265 qualified patients were retrospectively analyzed. A prognostic score was constructed using predictors associated with early recurrence (ER). Based on the HR value, AFP > 400 ng/ml and hepatitis B viral e antigen (HBeAg) positivity were assigned as 1 point, satellite nodule was assigned 2 points. There were five subgroups (score 0/1/2/3/4). Due to similar RFS in score 2/3/4 subgroups, we merged these into a single cohort (group C), while maintaining score 0 as group A and score 1 as group B. RESULTS: MVI (+) HCC patients who developed ER had dramatically decreased overall survival (OS) compared with those who did not(P < 0.001). Based on the result of multivariable analysis, MVI (+) HCC patients with satellite nodules, positive HBeAg or serum alpha-fetoprotein above 400ng/ml were more likely to developed ER. The 3-year recurrence free survival rates for the group A, group B and group C were 42.7%, 26.4% and 9.3%, respectively. The 3-year OS rates for group A, group B and group C were 65.4%, 48.7% and 26.9%, respectively (p < 0.001). A higher score was correlated with significantly worse prognosis (p < 0.001). Furthermore, the prognostic score distinguished the prognosis of MVI (+) HCC patients independently of liver cirrhosis (p < 0.001). CONCLUSIONS: The prognostic score consisted of ER-related factors effectively predict prognosis for MVI (+) HCC patients after hepatectomy.

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