Risk Factors Of Early Recurrence After Resection Of Hepatocellular Carcinoma And Its Construction Of Prognostic Model

PartObjective(s):Numerous studies have shown that preoperative serum glutamyl transferase-platelet values correlate with the prognosis of patients with hepatocellular carcinoma after hepatic resection.However,the findings remain controversial.Therefore,a meta-analysis of nine studies was performed to assess the prognostic value of preoperative GPR in people with HCC.Method(s):Pub Med,Embase,Cochrane,Web of Science,and other Chinese databases.Risk ratios(HR)or odds ratios(OR)and their 95% confidence intervals(CI)were used to assess the association between preoperative GPR and prognosis or clinical features in patients with HCC.Result(s):This meta-analysis was screened for inclusion in a total of nine studies.Compared with low GPR,elevated preoperative GPR was strongly associated with shorter OS with postoperative HCC,with a pooled HR of 1.93(95% CI 1.60 to 2.33).Conclusion(s):This meta-analysis showed that patients with elevated preoperative GPR were significantly associated with overall survival after hepatic resection for liver cancer,which may be a valid prognostic indicator.Part ⅡObjective(s):A Nomogram prediction model was established to predict the recurrence probability of patients in order to give patients a more appropriate treatment plan before surgery.Method(s):A retrospective analysis was performed on the clinical data of 613 liver cancer patients who underwent hepatectomy in Liuzhou People’s Hospital from January 2013 to December 2020.Univariate and multivariate analysis of preoperative clinical data was performed using Cox regression analysis,and meaningful variables(P<0.5)were included in the final Nomogram prediction model.The prediction accuracy of the model is verified by C-index and calibration curve.Result(s):From January 1,2013 to December 30,2020,a total of 613 liver cancer patients were surgically resected in Liuzhou People’s Hospital,of which 279 patients met the inclusion criteria.The median postoperative recurrence was 351 days(11-2102 days),the recurrence rate of early recurrence was 46.4%,and the resection of more than hemi-hepatic accounted for 37.9%.The Nomogram model,which predicted recurrence based on preoperative data,had a C-index of 0.71(95% CI,0.65-0.78)for predicting recurrence.The calibration curve of the Nomogram model has a high degree of agreement between the predicted survival and the actual survival.Multivariate analysis of preoperative clinicopathological data showed that diabetes,AFP,APTT,ARPI,GPR,tumor number,and microvascular invasion were independent risk factors for recurrence.Conclusion(s):The Nomogram predictive model of this study accurately predicted early recurrence after surgery in liver cancer patients.