Prognostic Analysis of Single Large Hepatocellular Carcinoma Following Radical Resection: A Single-Center Study

Figures & data

Table 1 Clinicopathologic Characteristics of All Patients and Univariate Analysis for OS and RFS

Variables	Number (Percentage)	OS			RFS
		HR	95% CI	P	HR	95% CI	P
Age, year
≥60	120 (24.7%)	1.080	0.814–1.434	0.593	1.059	0.813–1.378	0.672
<60	365 (75.3%)
Sex
Male	406 (83.7%)	1.442	0.995–2.091	0.053	1.761	1.225–2.532	0.002
Female	79 (16.3%)
HBsAg
Positive	431 (88.9%)	1.107	0.742–1.652	0.618	1.167	0.803–1.695	0.418
Negative	54 (11.1%)
AFP, μg/L
>400	213 (43.9%)	1.669	1.301–2.142	<0.001	1.394	1.105–1.759	0.005
≤400	272 (56.1%)
CEA, μg/L
>10	7 (1.4%)	1.899	0.707–5.104	0.203	1.511	0.563–4.055	0.413
≤10	478 (98.6%)
CA199, U/mL
>39	72 (14.8%)	1.208	0.861–1.695	0.274	1.239	0.904–1.699	0.183
≤39	413 (85.2%)
TB, μmol/L
≥17.1	108 (22.3%)	1.632	1.24–2.147	<0.001	1.419	1.089–1.849	0.010
<17.1	377 (77.7%)
ALB, g/L
≥40	326 (67.2%)	1.275	0.984–1.652	0.066	1.092	0.854–1.397	0.482
<40	159 (32.8%)
ALT, U/L
>40	212 (43.7%)	1.069	0.833–1.374	0.599	1.105	0.876–1.395	0.399
≤40	273 (56.3%)
AST, U/L
>40	243 (50.1%)	1.446	1.125–1.858	0.004	1.308	1.037–1.65	0.023
≤40	242 (49.9%)
GGT, U/L
>60	333 (68.7%)	1.789	1.337–2.394	<0.001	1.785	1.367–2.33	<0.001
≤60	152 (31.3%)
LDH, U/L
>225	177 (36.5%)	1.896	1.475–2.436	<0.001	1.770	1.399–2.24	<0.001
≤225	308 (63.5%)
ALP, U/L
≤130	382 (78.8%)	1.760	1.33–2.331	<0.001	1.303	0.98–1.733	0.069
>130	103 (21.2%)
Child-Pugh
A	472 (97.3%)	1.451	0.717–2.936	0.300	0.251	0.062–1.009	0.051
B	13 (2.7%)
Blood loss, mL
<400	285 (58.8%)	1.449	1.129–1.859	0.004	1.376	1.09–1.736	0.007
≥400	200 (41.2%)
Hepatic hilar occlusion time, min
<30	409 (84.3%)	1.274	0.919–1.764	0.146	1.356	0.999–1.841	0.051
≥30	76 (15.7%)
Tumor size, cm
≤10	354 (73.0%)	1.331	1.014–1.747	0.040	1.120	0.862–1.454	0.396
>10	131 (27.0%)
Liver cirrhosis
Yes	229 (47.2%)	1.583	1.233–2.034	<0.001	1.429	1.133–1.802	0.003
No	256 (52.8%)
MVI
Yes	173 (35.7%)	1.907	1.484–2.45	<0.001	1.801	1.423–2.279	<0.001
No	312 (64.3%)
Satellite lesions
Yes	147 (30.3%)	2.205	1.71–2.842	<0.001	1.880	1.477–2.392	<0.001
No	338 (69.7%)
Edmondson-Steiner grade
I+II	61 (12.6%)	2.158	1.379–3.377	0.001	1.571	1.087–2.27	0.016
III+IV	424 (87.4%)

Note: P<0.05 was defined as statistical significance (italicized and bold).

Abbreviations: HBsAg, Hepatitis B surface antigen; AFP, alpha-fetoprotein; CEA, carcino-embryonic antigen; CA19-9, carbohydrate antigen 19-9; TB, total bilirubin; ALB, albumin; ALT, alanine transaminase; AST, aspartate aminotransferase; GGT, γ-glutamyl transferase; LDH, lactate dehydrogenase; ALP, alkaline phosphatase; MVI, microvascular invasion; OS, overall survival; RFS, recurrence free survival; CI, confidence interval; HR, hazard ratios.

Figure 1 Kaplan-Meier curves for SLHCC patient OS (a) and RFS (b).

Abbreviations: SLHCC, single large hepatocellular carcinoma; OS, overall survival; RFS, recurrence-free survival.

Table 2 Multivariate Analysis of SLHCC Patients for OS

Variables	B	SE	Wald	HR	95% CI	P
Liver cirrhosis (Yes / No)	0.376	0.129	8.425	1.456	1.130–1.877	0.004
TB (≥17.1 / <17.1, μmol/L)	0.363	0.143	6.429	1.437	1.086–1.903	0.011
GGT (>60 / ≤60, U/L)	0.363	0.156	5.453	1.438	1.060–1.951	0.020
LDH (>225 / ≤225, U/L)	0.366	0.135	7.387	1.442	1.108–1.879	0.007
Blood loss (≥400 / <400, mL)	0.292	0.132	4.874	1.339	1.033–1.735	0.027
MVI (Yes / No)	0.400	0.138	8.428	1.492	1.139–1.955	0.004
Satellite lesions (Yes / No)	0.620	0.138	20.183	1.859	1.418–2.436	<0.001
Edmondson-Steiner grade (I+II / III+IV)	0.554	0.234	5.607	1.740	1.100–2.753	0.018

Note: P<0.05 was defined as statistical significance (italicized).

Abbreviations: TB, total bilirubin; GGT, γ-glutamyl transferase; LDH, lactate dehydrogenase; MVI, microvascular invasion; SLHCC, single large hepatocellular carcinoma; OS, overall survival; CI, confidence interval; HR, hazard ratios.

Figure 2 Kaplan-Meier curves for the results of multivariate analysis for OS.

Table 3 Multivariate Analysis of SLHCC Patients for RFS

Variables	B	SE	Wald	HR	95% CI	P
Sex (Male / Female)	0.567	0.188	9.124	1.763	1.220–2.547	0.003
Liver cirrhosis (Yes / No)	0.323	0.120	7.278	1.382	1.092–1.747	0.007
GGT (>60 / ≤60, U/L)	0.414	0.141	8.599	1.512	1.147–1.994	0.003
LDH (>225 / ≤225, U/L)	0.392	0.124	9.981	1.480	1.160–1.888	0.002
MVI (Yes / No)	0.435	0.128	11.467	1.545	1.201–1.987	0.001
Satellite lesions (Yes / No)	0.447	0.130	11.771	1.564	1.211–2.019	0.001

Note: P<0.05 was defined as statistical significance (italicized).

Abbreviations: GGT, γ-glutamyl transferase; LDH, lactate dehydrogenase; MVI, microvascular invasion; SLHCC, single large hepatocellular carcinoma; RFS, recurrence-free survival; CI, confidence interval; HR, hazard ratios.

Figure 3 Kaplan-Meier curves for the results of multivariate analysis for RFS.

Figure 4 Nomograms for predicting prognosis in SLHCC patients. (a) Overall survival (OS). (b) Recurrence-free survival (RFS).

Abbreviations: TB, total bilirubin; GGT, γ-glutamyl transferase; LDH, lactate dehydrogenase; MVI, microvascular invasion.

Figure 5 Calibration curves of nomograms for predicting OS and RFS of SLHCC patients at 1-,3-and 5-years. a-c. 1- (a), 3- (b) and 5- (c) year OS. d-f. 1- (d), 3- (e) and 5- (f) year RFS.

Abbreviations: OS, overall survival; RFS, recurrence-free survival.

Figure 6 Kaplan-Meier curves for OS (a) and RFS (b) of patients in different risk groups based on the nomogram scores.

Abbreviations: OS, overall survival; RFS, recurrence-free survival.