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Cancer Management and Research Volume 11, 2019 - Issue
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Original Research

Aspartate aminotransferase-to-platelet ratio index predicts prognosis of hepatocellular carcinoma after postoperative adjuvant transarterial chemoembolization

Gui-Qi Zhu1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
,
Kang Wang3 Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 40016, China
,
Biao Wang1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
,
Yu-Jie Zhou4 Department of Gastroenterology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
,
Yi Yang1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
,
Er-Bao Chen5 Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
,
Zheng-Jun Zhou1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
,
Shao-Lai Zhou1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
,
Ying-Hong Shi1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
,
Jian Zhou1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]
&
Zhi Dai1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China, [email protected];2 State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China, [email protected]Correspondence[email protected]
 show all
Pages 63-79 | Published online: 20 Dec 2018

Figures & data

Table 1 Demographic, biochemical, virological, and tumor characteristics of the study patients

Figure 1 Graphs show cumulative DFS and recurrence rates in patients with HCC after PATACE.

Notes: (A) Patients with higher APRI had better 3-year DFS benefits than those with low APRI score (P=0.013); (B) patients with higher APRI had better 5-year DFS benefits than those with low APRI score (P<0.01); (C) patients with higher APRI had lower OS than those with low APRI score (P=0.0035).

Abbreviations: APRI, aspartate aminotransferase-to-platelet ratio index; DFS, disease-free survival; HCC, hepatocellular carcinoma; OS, overall survival; PATACE, postoperative adjuvant transarterial chemoembolization.

Figure 1 Graphs show cumulative DFS and recurrence rates in patients with HCC after PATACE.Notes: (A) Patients with higher APRI had better 3-year DFS benefits than those with low APRI score (P=0.013); (B) patients with higher APRI had better 5-year DFS benefits than those with low APRI score (P<0.01); (C) patients with higher APRI had lower OS than those with low APRI score (P=0.0035).Abbreviations: APRI, aspartate aminotransferase-to-platelet ratio index; DFS, disease-free survival; HCC, hepatocellular carcinoma; OS, overall survival; PATACE, postoperative adjuvant transarterial chemoembolization.

Table 2 Factors associated with poor DFS after surgical resection for HCC according to univariate and multivariate analyses

Table 3 Factors associated with TTR after surgical resection for HCC according to univariate and multivariate analysis

Table 4 Subgroup analysis for the effect of APRI on DFS and TTR of HCC

Figure 2 Nomogram shows assessment of 3- and 5-year DFS of patients with HCC who underwent PATACE.

Notes: (A) Nomogram shows assessment of 5-year DFS of patients with HCC who underwent PATACE. (B) Nomogram shows assessment of 3-year DFS of patients with HCC who underwent PATACE.

Abbreviations: ALT, alanine aminotransferase level; APRI, aspartate aminotransferase-to-platelet ratio index; BCLC, Barcelona Clinic Liver Cancer grade; DFS, disease-free survival; HCC, hepatocellular carcinoma; PLT count, platelet count; PATACE, postoperative adjuvant transarterial chemoembolization.

Figure 2 Nomogram shows assessment of 3- and 5-year DFS of patients with HCC who underwent PATACE.Notes: (A) Nomogram shows assessment of 5-year DFS of patients with HCC who underwent PATACE. (B) Nomogram shows assessment of 3-year DFS of patients with HCC who underwent PATACE.Abbreviations: ALT, alanine aminotransferase level; APRI, aspartate aminotransferase-to-platelet ratio index; BCLC, Barcelona Clinic Liver Cancer grade; DFS, disease-free survival; HCC, hepatocellular carcinoma; PLT count, platelet count; PATACE, postoperative adjuvant transarterial chemoembolization.

Figure 3 Calibration plot of the nomogram.

Notes: (A) Calibration curves of the nomogram at 5-year DFS. (B) Calibration curves of the nomogram at 3-year DFS. Calibration curves of the nomogram at 3 years (right) and 5 years (left) were close to 45° line, which shows good correlation between assessed and observed DFS.

Abbreviation: DFS, disease-free survival.

Figure 3 Calibration plot of the nomogram.Notes: (A) Calibration curves of the nomogram at 5-year DFS. (B) Calibration curves of the nomogram at 3-year DFS. Calibration curves of the nomogram at 3 years (right) and 5 years (left) were close to 45° line, which shows good correlation between assessed and observed DFS.Abbreviation: DFS, disease-free survival.

Figure S1 Patient flow diagram.

Abbreviations: HCC, hepatocellular carcinoma; TACE, transarterial chemoembolization.

Figure S1 Patient flow diagram.Abbreviations: HCC, hepatocellular carcinoma; TACE, transarterial chemoembolization.

Figure S2 X-tile plots of the optimal cutoff point for the APRI.

Notes: Coloration of the plot represents the strength of the association at each division, ranging from low (dark, black) to high (bright, red or green). Green indicates a direct association between score and survival, whereas black indicates an inverse association.

Abbreviation: APRI, aspartate aminotransferase-to-platelet ratio index.

Figure S2 X-tile plots of the optimal cutoff point for the APRI.Notes: Coloration of the plot represents the strength of the association at each division, ranging from low (dark, black) to high (bright, red or green). Green indicates a direct association between score and survival, whereas black indicates an inverse association.Abbreviation: APRI, aspartate aminotransferase-to-platelet ratio index.

Figure S3 Nomogram shows assessment of time to recurrence of patients with HCC who underwent PATACE.

Abbreviations: HCC, hepatocellular carcinoma; APRI, aspartate aminotransferase-to-platelet ratio index; ALT, alanine aminotransferase; PLT count, platelet count; PATACE, postoperative adjuvant transarterial chemoembolization.

Figure S3 Nomogram shows assessment of time to recurrence of patients with HCC who underwent PATACE.Abbreviations: HCC, hepatocellular carcinoma; APRI, aspartate aminotransferase-to-platelet ratio index; ALT, alanine aminotransferase; PLT count, platelet count; PATACE, postoperative adjuvant transarterial chemoembolization.

Figure S4 Calibration plot of the nomogram.

Notes: Calibration curves of the nomogram at time to recurrence shows good correlation between assessed and observed outcomes. Calibration curves were close to 45° line.

Figure S4 Calibration plot of the nomogram.Notes: Calibration curves of the nomogram at time to recurrence shows good correlation between assessed and observed outcomes. Calibration curves were close to 45° line.

Table S1 Assessment accuracy of serum markers for overall DFS and recurrence for hepatocellular carcinoma after curative resection

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