Table 3.
Prognostic factors for recurrence-free 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) | 0.994 | 0.807–1.229 | 0.955 | |||
| <65 years (n = 211) | 1.000 | (referent) | ||||
| Sex | ||||||
| Male (n = 484) | 1.047 | 0.817–1.359 | 0.721 | |||
| Female (n = 122) | 1.000 | (referent) | ||||
| Etiology of HCC | ||||||
| HBV and/or HCV (n = 392) | 1.111 | 0.900–1.378 | 0.330 | |||
| Others (n = 214) | 1.000 | (referent) | ||||
| Previous treatment for HCC | ||||||
| Yes (n = 228) | 1.377 | 1.122–1.687 | 0.002 | |||
| No (n = 378) | 1.000 | (referent) | ||||
| Obesity-related comorbidities | ||||||
| Yes(n = 361) | 0.867 | 0.709–1.064 | 0.172 | |||
| No(n = 245) | 1.000 | (referent) | ||||
| Period of hepatectomy | ||||||
| 2005–2009 (n = 302) | 1.319 | 1.074–1.626 | 0.008 | |||
| 2010–2016 (n = 304) | 1.000 | (referent) | ||||
| Platelet count | ||||||
| <10 × 104/mm3 (n = 128) | 1.194 | 0.930–1.516 | 0.162 | |||
| ≥10 × 104/mm3 (n = 478) | 1.000 | (referent) | ||||
| Total lymphocyte count | ||||||
| <1,000/mm3 (n = 156) | 1.056 | 0.835–1.330 | 0.633 | |||
| ≥1,000/mm3 (n = 450) | 1.000 | (referent) | ||||
| Neutrophil-to-lymphocyte ratio | ||||||
| <4.0 (n = 547) | 0.942 | 0.675–1.357 | 0.737 | |||
| ≥4.0 (n = 59) | 1.000 | (referent) | ||||
| Total bilirubin | ||||||
| ≥1.0 mg/dL (n = 187) | 1.252 | 1.008–1.548 | 0.042 | |||
| <1.0 mg/dL (n = 419) | 1.000 | (referent) | ||||
| Albumin | ||||||
| <3.5 g/dL (n = 100) | 1.244 | 0.939–1.622 | 0.126 | |||
| ≥3.5 g/dL (n = 506) | 1.000 | (referent) | ||||
| ICG R15 | ||||||
| ≥15% (n = 312) | 1.172 | 0.957–1.435 | 0.124 | |||
| <15% (n = 294) | 1.000 | (referent) | ||||
| Child-Pugh class | ||||||
| A (n = 555) | 0.873 | 0.615–1.287 | 0.479 | |||
| B (n = 51) | 1.000 | (referent) | ||||
| AFP | ||||||
| ≥20 ng/dL (n = 294) | 1.431 | 1.169–1.751 | 0.001 | 1.370 | 1.109–1.695 | 0.004 |
| <20 ng/dL (n = 312) | 1.000 | (referent) | 1.000 | (referent) | ||
| DCP | ||||||
| ≥40 mAU/mL (n = 428) | 1.418 | 1.134–1.787 | 0.002 | |||
| <40 mAU/mL (n = 178) | 1.000 | (referent) | ||||
| Liver histology | ||||||
| Normal liver or chronic hepatitis | ||||||
| (n = 305) | 0.898 | 0.734–1.098 | 0.295 | |||
| Liver fibrosis or liver cirrhosis | ||||||
| (n = 301) | 1.000 | (referent) | ||||
| Tumor size | ||||||
| ≥5.0 cm (n = 209) | 1.549 | 1.254–1.905 | <0.001 | |||
| <5.0 cm (n = 397) | 1.000 | (referent) | ||||
| Number of tumors | ||||||
| Multiple(n = 189) | 1.731 | 1.402–2.130 | <0.001 | |||
| Solitary (n = 417) | 1.000 | (referent) | ||||
| MVI | ||||||
| Positive (n = 196) | 1.934 | 1.566–2.380 | <0.001 | |||
| Negative (n = 410) | 1.000 | (referent) | ||||
| Tumor differentiation | ||||||
| Well or moderate (n = 424) | 0.707 | 0.566–0.889 | 0.003 | 0.851 | 0.673–1.082 | 0.186 |
| Poor(n = 167) TNM stage | 1.000 | (referent) | 1.000 | (referent) | ||
| I or II (n = 361) | 0.461 | 0.377–0.565 | <0.001 | 0.455 | 0.366–0.566 | <0.001 |
| III or IV (n = 245) | 1.000 | (referent) | 1.000 | (referent) | ||
| Surgical procedure | ||||||
| Lobectomy or more (n = 210) | 1.469 | 1.190–1.806 | <0.001 | |||
| Less than segmentectomy (n = 396) | 1.000 | (referent) | ||||
| Operative time | ||||||
| ≥360 min (n = 318) | 1.169 | 0.956–1.431 | 0.128 | |||
| <360 min (n = 288) | 1.000 | (referent) | ||||
| Operative blood loss | ||||||
| ≥500 mL(n = 378) | 1.318 | 1.069–1.631 | 0.010 | 0.962 | 0.767–1.211 | 0.739 |
| <500 mL (n = 228) | 1.000 | (referent) | 1.000 | (referent) | ||
| BMI | ||||||
| ≥25(n = 157) | 1.000 | 0.793–1.250 | 0.999 | |||
| <25 (n = 449) | 1.000 | (referent) | ||||
| Preoperative SMI | ||||||
| Low (n = 84) | 1.456 | 1.087–1.914 | 0.013 | 1.447 | 1.074–1.913 | 0.016 |
| Normal(n = 522) | 1.000 | (referent) | 1.000 | (referent) | ||
| Preoperative IMAC | ||||||
| High (n = 258) | 1.205 | 1.013–1.497 | 0.044 | 1.234 | 1.001–1.493 | 0.049 |
| Normal(n = 348) | 1.000 | (referent) | 1.000 | (referent) | 0.049 | |
| Preoperative VSR | ||||||
| High(n = 252) | 1.283 | 1.047–1.571 | 0.017 | 1.329 | 1.047–1.685 | 0.020 |
| 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.