Prognostic significance of the preoperative alkaline phosphatase‑to‑albumin ratio in patients with hepatocellular carcinoma after hepatic resection

Yikai Wang; Xinyu Bi; Hong Zhao; Zhiyu Li; Jianjun Zhao; Jianguo Zhou; Zhen Huang; Yefan Zhang; Xiao Chen; Chongda Zhang; Jianqiang Cai; Yijun Ren

doi:10.3892/ol.2023.13733

Prognostic significance of the preoperative alkaline phosphatase‑to‑albumin ratio in patients with hepatocellular carcinoma after hepatic resection

Oncol Lett. 2023 Mar 1;25(4):147. doi: 10.3892/ol.2023.13733. eCollection 2023 Apr.

Authors

Yikai Wang¹, Xinyu Bi², Hong Zhao², Zhiyu Li², Jianjun Zhao², Jianguo Zhou², Zhen Huang², Yefan Zhang², Xiao Chen², Chongda Zhang³, Jianqiang Cai², Yijun Ren¹

Affiliations

¹ Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China.
² Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.
³ New York University Medical Center, New York University, New York, NY 10016, USA.

Abstract

This study aimed to investigate the prognostic value of the preoperative alkaline phosphatase-to-albumin ratio (APAR) in patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy. The clinicopathological data from 330 patients was retrospectively analyzed. Receiver operating characteristic curves of APAR for diagnostic tumor recurrence were plotted with a cut-off value of 1.74. A high preoperative APAR value was significantly associated with hepatitis B surface antigen level, tumor diameter, and tumor-node-metastasis stage. The disease-free survival (DFS) and overall survival (OS) of patients with a high preoperative APAR were shorter than those with a low APAR. The independent risk factors for DFS were an APAR ≥1.74, and macrovascular invasion or tumor thrombus. The independent risk factors for OS were an APAR ≥1.74, existing clinical symptoms, α-fetoprotein level ≥20 ng/ml, macrovascular invasion or tumor thrombus, and family history of cancer. In conclusion, a preoperative APAR (≥1.74) is an independent risk factor influencing the poor prognosis of patients with HCC after curative hepatectomy, and patients with such a result should be closely monitored.

Keywords: alkaline-phosphatase-to-albumin ratio; hepatectomy; hepatocellular carcinoma; prognosis; survival rate.

Grants and funding

This work was financially supported by the National High-tech R&D (863) Program of China (grant no. SS2015AA020408), Fundamental Research Funds of Central Universities (grant no. 2042022kf1076), Natural Science Foundation of Hubei Province (grant on. 2020CFB659), and the Research Foundation of Hubei Provincial Health Commission (grant no. WJ2021M139).