LI Meixia 1 , QIN Li 1 , QIU Zhancheng 2 , CHEN Tinghao 3 , XIE Fei 4 , YU Yu 5 , LENG Shusheng 6 , QI Weili 2 , LUO Siyuan 2 , WU Youwei 2 , XU Yueqing 2 , LI Chuan 2,3
  • 1. Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 2. Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 3. Department of Hepatobiliary and Pancreatic Surgery, West China Ziyang Hospital/Ziyang Central Hospital, Ziyang, Sichuan 641399, P. R. China;
  • 4. Department of Hepatobiliary and Pancreatic Surgery, The First People’s Hospital of Neijiang, Neijiang, Sichuan 641000, P. R. China;
  • 5. Department of Hepatobiliary and Pancreatic Surgery, West China Yibin Hospital/The Second People’s Hospital of Yibin, Yibin, Sichuan 644002, P. R. China;
  • 6. Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Chengdu University, Chengdu 610081, P. R. China;
LI Chuan, Email: lichuan@scu.edu.cn
hepatocellular carcinoma; alpha fetoprotein-tumor burden score; hepatectomy; prognosis
10.7507/1007-9424.202408123
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Objective  To study the effect of alpha fetoprotein-tumor burden score (ATS) on the long-term prognosis of hepatocellular carcinoma (HCC) after resection. Methods The data of 2 907 patients with HCC who underwent first hepatectomy from West China Hospital of Sichuan University, West China Ziyang Hospital/Ziyang Central Hospital, The First People’s Hospital of Neijiang, West China Yibin Hospital/the Second People’s Hospital of Yibin, and the Affiliated Hospital of Chengdu University between 2015 and 2022, were retrospectively analyzed. The X-tile software was used to calculate the optimal truncation of the ATS score. Cox proportional hazard regression model was used to explore risk factors affecting postoperative recurrence-free survival (RFS) and overall survival (OS) in HCC patients, respectively. Results All patients were followed-up with a median of 37 months (1–90 months), 1 364 cases (46.9%, the recurrence time was 1–89 months after surgery) of them experienced recurrence and 847 cases (29.1%) died (the death time was 1–88 months after surgery). The 1-, 2- and 3-year OS rates were 89.3%, 81.4% and 75.9%, respectively. The 1-, 2- and 3-year RFS rates were 76.0%, 64.3% and 57.2%, respectively. The 5-year RFS rate of HCC patients with low-, medium-, and high-ATS scores were 56.4%, 45.0% and 27.2%, respectively, and patients with low ATS score had better RFS (χ2=264.747, P<0.001). The 5-year OS rates of HCC patients with low-, medium-, and high-ATS scores were 78.0%, 59.8% and 38.8%, respectively, and patients with low-ATS score had better OS (χ2=372.685, P<0.001). Multivariate Cox proportional hazard regression model suggested that, in condition of adjusting other factors, medium-ATS score [RR=1.375, 95%CI (1.209, 1.564), P<0.001] and high-ATS score [RR=2.048, 95%CI (1.764, 2.377), P<0.001] were risk factors for postoperative RFS; the medium-ATS score [RR=1.779, 95%CI (1.499, 2.112), P<0.001] and high ATS score [RR=2.676, 95%CI (2.211, 3.239), P<0.001] were also risk factors affecting postoperative OS. Conclusion ATS score can predict the prognosis of HCC patients after resection, patients with high ATS score had a higher incidence of postoperative recurrence and mortality.

Citation： LI Meixia, QIN Li, QIU Zhancheng, CHEN Tinghao, XIE Fei, YU Yu, LENG Shusheng, QI Weili, LUO Siyuan, WU Youwei, XU Yueqing, LI Chuan. Alpha fetoprotein-tumor burden score predicts prognosis of patients with hepatocellular carcinoma after hepatectomy: a multicenter retrospective cohort study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(2): 192-198. doi: 10.7507/1007-9424.202408123 Copy

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