Metavir and FIB-4 scores are associated with patient prognosis after curative hepatectomy in hepatitis B virus-related hepatocellular carcinoma: a retrospective cohort study at two centers in China

Abstract

Although Metavir and Fibrosis-4 (FIB-4) scores are typically used to assess the severity of liver fibrosis, the relationship between these scores and patient outcome in hepatocellular carcinoma (HCC) is unclear. The aim of this study was to evaluate the prognostic value of the severity of hepatic fibrosis in HBV-related HCC patients after curative resection. We examined the prognostic roles of the Metavir and preoperative FIB-4 scores in 432 HBV-HCC patients who underwent curative resection at two different medical centers located in western (Chongqing) and eastern (Shanghai) China. In the testing set (n = 108), the Metavir, FIB-4, and combined Metavir/FIB-4 scores were predictive of overall survival (OS) and recurrence-free survival (RFS). Additionally, they were associated with several clinicopathologic variables. In the validation set (n = 324), the Metavir, FIB-4, and combined Metavir/FIB-4 scores were associated with poor prognosis in HCC patients after curative resection. Importantly, in the negative alpha-fetoprotein subgroup (≤ 20 ng/mL), the FIB-4 index (I vs. II) could discriminate between patient outcomes (high or low OS and RFS). Thus Metavir, preoperative FIB-4, and combined Metavir/FIB-4 scores are prognostic markers in HBV-HCC patients after curative hepatectomy.

Inflammation-nutrition scope predicts prognosis of early-stage hepatocellular carcinoma after curative resection

“…[ 3 ] Several studies have shown the prognostic significance of FIB-4 index, PLR, and NLR score in postsurgery patients with HCC. [ 10 , 13 , 14 ] In this study, a novel index, defined as INS, based on systemic inflammatory response and nutritional status, was developed. The prognostic value of the INS in patients with HCC who underwent surgery was evaluated in 2 independent cohorts.…”

“…[ 5 , 6 ] Moreover, there is a wealth of evidence to suggest that systemic inflammation can predict the outcome of survival and recurrence after surgical resection in HCC. [ 7 ] Interestingly, several studies have previously shown that some serum parameters such as markers of systemic inflammation, including platelet count (PLT), hemoglobin, fibrosis index based on the 4 factors (FIB-4) index, neutrophil–lymphocyte ratio (NLR), and platelet–lymphocyte ratio (PLR), have been developed to predict survival of a variety of human cancers, [ 8 – 13 ] including HCC. [ 14 – 16 ]…”

Cost-effectiveness of Universal and Targeted Hepatitis C Virus Screening in the United States

“…Disease progression was described in terms of METAVIR score, a liver biopsy staging system that assesses the severity of liver fibrosis. 40 METAVIR scores assess the degree of scarring or fibrosis of the liver, ranging from F0 (no fibrosis) to F4 (cirrhosis). Health states were categorized in 2 main phases of disease progression: fibrosis progression stages F0 to F4, and nonfibrosis progression after stage F4.…”

“…Health states included healthy (no HCV), no fibrosis (F0), portal fibrosis with no septa (F1), portal fibrosis with few septa (F2), numerous septa without cirrhosis (F3), compensated cirrhosis (F4), decompensated cirrhosis, hepatocellular carcinoma, post–hepatocellular carcinoma, liver transplantation, and post–liver transplantation. 40 , 41 , 42 Without treatment, patients in the F0 state might experience spontaneous clearance of the HCV and return to a no HCV state in state F0. Otherwise, patients may progress to the next severity state of the disease ( Figure 1 ).…”

HBV-DNA Load-Related Peritumoral Inflammation and ALBI Scores Predict HBV Associated Hepatocellular Carcinoma Prognosis after Curative Resection

“…A total of 512 consecutive HCC patients undergoing curative resection were selected for retrospective analysis. Of these selected, 46 patients were excluded, according to the inclusion and exclusion criteria described previously [ 8 ]. Briefly, (1) all patients tested HBV surface antigen (HBsAg) and HBV-DNA loads; (2) reliable laboratory test data including liver function; (3) the absence of preoperative extrahepatic metastases confirmed by computed tomography (CT) and/or magnetic resonance imaging (MRI) scanning; (4) no preoperative anticancer therapies; (5) complete resection of all tumor nodules; (6) complete patient records and follow-up data; (7) survival for more than 30 days after surgery.…”