Table 2.
Prognostic factors for overall survival on univariate and multivariate analysis
| Univariate analysis |
Multivariate analysis |
|||||
|---|---|---|---|---|---|---|
| HR | 95% CI | p value | HR | 95% CI | p value | |
| Age | ||||||
| ≥65 years (n = 395) | 1.232 | 0.961–1.592 | 0.101 | |||
| <65 years (n = 211) | 1.000 | (referent) | ||||
| Sex | ||||||
| Male (n = 484) | 1.003 | 0.752–1.364 | 0.982 | |||
| Female (n = 122) Etiology of HCC | 1.000 | (referent) | ||||
| Etiology of HCC | ||||||
| HBV and/or HCV (n = 392) | 0.967 | 0.757–1.242 | 0.788 | |||
| Others (n = 214) | 1.000 | (referent) | ||||
| Previous treatment for HCC | ||||||
| Yes (n = 228) | 1.331 | 1.048–1.688 | 0.019 | |||
| No (n = 378) | 1.000 | (referent) | ||||
| Obesity-related comorbidities | ||||||
| Yes(n = 361) | 1.003 | 0.790–1.278 | 0.978 | |||
| No(n = 245) | 1.000 | (referent) | ||||
| Period of hepatectomy | ||||||
| 2005–2009 (n = 302) | 0.905 | 0.696–1.181 | 0.459 | |||
| 2010–2016 (n = 304) | 1.000 | (referent) | ||||
| Platelet count | ||||||
| <10 × 104/mm3 (n = 128) | 1.410 | 1.071–1.835 | 0.015 | 1.199 | 0.895–1.589 | 0.220 |
| ≥10 × 104/mm3 (n = 478) | 1.000 | (referent) | 1.000 | (referent) | ||
| Total lymphocyte count | ||||||
| <1,000/mm3 (n = 156) | 1.279 | 0.975–1.660 | 0.075 | |||
| ≥1,000/mm3 (n = 450) | 1.000 | (referent) | ||||
| Neutrophil-to-lymphocyte ratio | ||||||
| <4.0 (n = 547) | 0.750 | 0.514–1.143 | 0.174 | |||
| ≥4.0 (n = 59) | 1.000 | (referent) | ||||
| Total bilirubin | ||||||
| ≥1.0 mg/dL (n = 187) | 1.123 | 0.868–1.442 | 0.371 | |||
| <1.0 mg/dL (n = 419) | 1.000 | (referent) | ||||
| Albumin | ||||||
| <3.5 g/dL (n = 100) | 1.799 | 1.329–2.398 | <0.001 | 1.501 | 1.084–2.045 | 0.015 |
| ≥3.5 g/dL (n = 506) | 1.000 | (referent) | 1.000 | (referent) | ||
| ICG R15 | ||||||
| ≥15% (n = 312) | 1.195 | 0.944–1.516 | 0.139 | |||
| <15% (n = 294) | 1.000 | (referent) | ||||
| Child-Pugh class | ||||||
| A (n = 555) | 0.746 | 0.508–1.144 | 0.172 | |||
| B (n = 51) | 1.000 | (referent) | ||||
| AFP | ||||||
| ≥20 ng/dL (n = 294) | 1.792 | 1.412–2.282 | <0.001 | 1.590 | 1.236–2.050 | <0.001 |
| <20 ng/dL (n = 312) | 1.000 | (referent) | 1.000 | (referent) | ||
| DCP | ||||||
| ≥40 mAU/mL (n = 428) | 1.239 | 0.955–1.625 | 0.108 | |||
| <40 mAU/mL (n = 178) | 1.000 | (referent) | ||||
| Liver histology | ||||||
| Normal liver or chronic hepatitis | ||||||
| (n = 305) | 0.899 | 0.709–1.138 | 0.376 | |||
| Liver fibrosis or liver cirrhosis | ||||||
| (n = 301) | 1.000 | (referent) | ||||
| Tumor size | ||||||
| ≥5.0 cm (n = 209) | 1.609 | 1.265–2.041 | <0.001 | |||
| <5.0 cm (n = 397) | 1.000 | (referent) | ||||
| Number of tumors | ||||||
| Multiple (n = 189) | 1.542 | 1.206–1.962 | 0.001 | |||
| Solitary (n = 417) | 1.000 | (referent) | ||||
| MVI | ||||||
| Positive (n = 196) | 1.891 | 1.485–2.400 | <0.001 | |||
| Negative (n = 410) | 1.000 | (referent) | ||||
| Tumor differentiation | ||||||
| Well or moderate (n = 424) | 0.551 | 0.427–0.718 | <0.001 | 0.739 | 0.537–1.040 | 0.081 |
| Poor(n = 167) | 1.000 | (referent) | 1.000 | (referent) | ||
| TNM stage | ||||||
| I or II (n = 361) | 0.454 | 0.357–0.575 | <0.001 | 0.508 | 0.391–0.659 | <0.001 |
| III or IV (n = 245) | 1.000 | (referent) | 1.000 | (referent) | ||
| Surgical procedure | ||||||
| Lobectomy or more (n = 210) | 1.536 | 1.205–1.950 | 0.001 | |||
| Less than segmentectomy (n = 396) | 1.000 | (referent) | ||||
| Operative time | ||||||
| ≥360 min (n = 318) | 1.495 | 1.179–1.899 | 0.001 | |||
| <360 min (n = 288) | 1.000 | (referent) | ||||
| Operative blood loss | ||||||
| ≥500 mL(n = 378) | 1.644 | 1.269–2.151 | <0.001 | 1.012 | 0.758–1.362 | 0.936 |
| <500 mL (n = 228) | 1.000 | (referent) | 1.000 | (referent) | ||
| BMI | ||||||
| ≥25(n = 157) | 0.994 | 0.753–1.296 | 0.964 | |||
| <25 (n = 449) | 1.000 | (referent) | ||||
| Preoperative SMI | ||||||
| Low (n = 84) | 1.506 | 1.077–2.058 | 0.018 | 1.333 | 1.007–1.752 | 0.045 |
| Normal(n = 522) | 1.000 | (referent) | 1.000 | (referent) | ||
| Preoperative IMAC | ||||||
| High (n = 258) | 1.918 | 1.500–2.468 | <0.001 | 1.774 | 1.375–2.302 | <0.001 |
| Normal(n = 348) | 1.000 | (referent) | 1.000 | (referent) | ||
| Preoperative VSR | ||||||
| High(n = 252) | 1.656 | 1.308–2.099 | <0.001 | 1.566 | 1.222–2.008 | <0.001 |
| Normal (n = 354) | 1.000 | (referent) | 1.000 | (referent) | ||
HR, hazard ratio; CI, confidence interval; HCC, hepatocellular carcinoma; HBV, hepatitis B virus; HCV, hepatitis C virus; ICG R15, indocyanine green retention test at 15 min; AFP, α-fetoprotein; DCP, des-γ-carboxyprothrombin; MVI, microvascular invasion; TNM, Tumour-Node-Metastasis (stage defined by the Liver Cancer Study Group of Japan); BMI, body mass index; SMI, skeletal muscle mass index; IMAC, intramuscular adipose tissue content; VSR, visceral-to-subcutaneous adipose tissue area ratio.