FIB-4 index for assessing the prognosis of hepatocellular carcinoma in patients with Child-Pugh class A liver function.

Abstract

PURPOSE:

We evaluated the prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh (C-P) class A based on FIB-4 index, which is a liver fibrosis marker.

PATIENTS AND METHODS:

A total of 915 HCC patients with C-P class A were investigated. We assessed the prognosis using FIB-4 index, and factors associated with survival rates were analyzed in these patients.

RESULTS:

When patients were categorized according to FIB-4 index as <2.0 (n = 93), ≥ 2.0 and <4.0 (n = 311), and ≥ 4.0 (n = 511), survival rates at 5 years were 70.5% [95% confidence interval (CI) 59.0-79.9], 56.4% (95% CI 50.1-62.5), and 47.1% (95% CI 42.2-52.1), respectively. Patients with FIB-4 index <2.0 had a higher survival rate than the other groups (≥ 4.0 vs ≥ 2.0 and <4.0, p = 0.010; ≥ 2.0 and <4.0 vs <2.0, p = 0.028). We were able to predict prognosis in patients with C-P score 5 by FIB-4 index, but survival rate did not significantly differ in patients with C-P score 6. Multivariate analysis identified C-P score, FIB-4 index [≥ 2.0 and <4.0; hazard ratios (HRs) 1.638 (95% CI 1.084-2.474); p = 0.019/≥ 4.0; HR 1.828 (95% CI 1.217-2.744); p = 0.004], Lens culinaris agglutinin-reactive α-fetoprotein, tumor size, number, vascular invasion, antiviral therapy, and hepatectomy as independent predictive factors for survival.

CONCLUSIONS:

The FIB-4 index is useful for assessing prognosis in HCC patients with C-P class A, especially those with C-P score 5.

• Authors: Takanori Ito, Takashi Kumada, Hidenori Toyoda, Toshifumi Tada
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 141 Issue 7 Pg. 1311-9 (Jul 2015) ISSN: 1432-1335 [Electronic] Germany
• PMID: 25648362 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Biomarkers
• Aspartate Aminotransferases
• Alanine Transaminase

Topics

• Age Factors
• Aged
• Alanine Transaminase (metabolism)
• Aspartate Aminotransferases (metabolism)
• Biomarkers (analysis)
• Carcinoma, Hepatocellular (blood, diagnosis, pathology, physiopathology)
• Female
• Health Status Indicators
• Humans
• Liver (metabolism, pathology, physiopathology)
• Liver Cirrhosis (complications, pathology)
• Liver Function Tests (methods)
• Liver Neoplasms (blood, diagnosis, pathology, physiopathology)
• Male
• Middle Aged
• Platelet Count
• Prognosis