Usefulness of a new inflammation-based scoring system for prognostication of patients with hepatocellular carcinoma after hepatectomy

Am J Surg. 2015 Jan;209(1):187-93. doi: 10.1016/j.amjsurg.2014.02.015. Epub 2014 May 21.

Abstract

Background: We investigated whether a preoperative scoring system (the "CRP-AFP Score [CAS]") based on the serum levels of C-reactive protein and alpha-fetoprotein would predict outcome in patients undergoing hepatectomy for hepatocellular carcinoma.

Methods: The CAS was defined as follows: patients with an elevated level of both C-reactive protein (>.3 mg/dL) and alpha-fetoprotein (>20 ng/mL) were assigned a score of 2, and patients showing one or none of these abnormalities were assigned a score of 1 or 0, respectively.

Results: A total of 349 patients were identified. Pathologic findings, in terms of tumor size, histologic grade, vascular invasion, intrahepatic metastasis, and recurrence rate, worsened as the CAS increased. CAS 2 patients had a poorer 5-year overall survival than CAS 0 or 1 patients (32.2% vs 59.7% vs 49.2%, respectively; P < .001).

Conclusions: The CAS is an informative scoring system that can predict outcome in patients with hepatocellular carcinoma after hepatectomy.

Keywords: Inflammation; Liver resection; Liver transplantation; Recurrence; Tumor marker.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / metabolism
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery
  • Decision Support Techniques*
  • Female
  • Hepatectomy*
  • Humans
  • Inflammation / blood
  • Inflammation / diagnosis*
  • Inflammation / etiology
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Survival Analysis
  • Treatment Outcome
  • alpha-Fetoproteins / metabolism

Substances

  • AFP protein, human
  • Biomarkers, Tumor
  • alpha-Fetoproteins
  • C-Reactive Protein