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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2016

01-08-2016 | Hepatobiliary Tumors

FIB-4 Index is a Predictor of Background Liver Fibrosis and Long-Term Outcomes After Curative Resection of Hepatocellular Carcinoma

Authors: Yukiyasu Okamura, MD, PhD, Ryo Ashida, MD, Yusuke Yamamoto, MD, Takaaki Ito, MD, PhD, Teiichi Sugiura, MD, PhD, Katsuhiko Uesaka, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 4/2016

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Abstract

Background

The FIB-4 index is a simple formula for predicting the degree of liver fibrosis. This study aimed to examine the relationship between the preoperative FIB-4 index and liver fibrosis in non-tumor regions of surgical specimens and to investigate whether the FIB-4 index is a useful predictor for long-term outcomes experienced by hepatocellular carcinoma (HCC) patients after curative resection.

Methods

This study retrospectively analyzed 493 HCC patients treated with curative resection. The utility of the FIB-4 index as a predictor of advanced liver fibrosis (F3 or F4) was assessed. The cutoff value for the FIB-4 index was determined using a receiver operating characteristic curve analysis, and the impact of the FIB-4 index on overall and recurrence-free survival after surgery was evaluated.

Results

Advanced liver fibrosis was found in 236 patients (47.9 %). The FIB-4 index was significantly higher for the patients with advanced liver fibrosis than for those without this condition (P < 0.001). An FIB-4 index of 2.87 was the optimal cutoff point for predicting advanced liver fibrosis. The multivariate analysis showed the FIB-4 index to be an independent prognostic factor for recurrence-free and overall survival after curative resection only for patients who underwent hepatectomy as initial treatment (hazard ratio, 1.47 and 1.59; 95 % confidence interval, 1.12–1.93 and 1.09–2.32; P = 0.006 and 0.016, respectively).

Conclusions

The study showed the FIB4-index to be a predictor of background liver fibrosis and long-term outcomes for HCC patients who underwent hepatectomy as their initial treatment.
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Metadata
Title
FIB-4 Index is a Predictor of Background Liver Fibrosis and Long-Term Outcomes After Curative Resection of Hepatocellular Carcinoma
Authors
Yukiyasu Okamura, MD, PhD
Ryo Ashida, MD
Yusuke Yamamoto, MD
Takaaki Ito, MD, PhD
Teiichi Sugiura, MD, PhD
Katsuhiko Uesaka, MD, PhD
Publication date
01-08-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 4/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5377-y

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Author Disclosure Summary

Japanese Society of Gastroenterological Surgery Article Series Disclosure Index