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Accepted for/Published in: JMIR Cancer

Date Submitted: Jul 31, 2024
Date Accepted: Jun 18, 2025

The final, peer-reviewed published version of this preprint can be found here:

Serum Alpha-Fetoprotein-Tumor Size Ratio as a Prognostic Marker After Hepatic Resection for Primary Hepatocellular Carcinoma: Propensity Score Matched Retrospective Cohort Study

Mo S, He Y, Liang T, Zhu G, Su H, Chuangye Han C, Peng T

Serum Alpha-Fetoprotein-Tumor Size Ratio as a Prognostic Marker After Hepatic Resection for Primary Hepatocellular Carcinoma: Propensity Score Matched Retrospective Cohort Study

JMIR Cancer 2025;11:e64929

DOI: 10.2196/64929

PMID: 40857604

PMCID: 12380365

Serum alpha-fetoprotein–tumor size ratio as a prognostic marker after hepatic resection for primary hepatocellular carcinoma: a propensity score matched retrospective cohort study

  • Shutian Mo; 
  • Yongfei He; 
  • Tianyi Liang; 
  • Guangzhi Zhu; 
  • Hao Su; 
  • Chuangye Chuangye Han; 
  • Tao Peng

ABSTRACT

Background:

Hepatocellular carcinoma (HCC) have a substantial recurrence rate and unfavorable prognosis after surgery, and effective prognostic indicators and stratification strategies are lacking.

Objective:

This study proposes new prognostic markers to provide a theoretical basis for patient management.

Methods:

The effect of alpha-fetoprotein (AFP)–tumor size ratio (ATR) on the prognosis of patients undergoing previous hepatectomy for HCC was investigated retrospectively. The optimal cut-off value was explored by X-tile. Independent risk factors for prognosis were investigated by Cox regression modelling, and between-group differences were reduced by propensity score matching (PSM). A predictive model for HCC prognosis was constructed by a nomogram.

Results:

Patients were classified into low, medium, and high groups based on ATR. Before PSM, ATR was an independent risk factor for OS (low vs. medium, HR:1.41 [1.03–1.94], P=.031; medium vs. high, HR:1.59 [1.02–2.47], P=.039) and an independent risk factor for RFS (low vs. medium, HR:1.33 [1.03–1.70], P=.026; medium vs. high, HR:2.10 [1.40–3.15], P<0.001). After PSM, ATR remain an independent risk factor. A nomogram based on ATR to predict moderate predictive efficacy for OS (C-index: 0.73) and RFS (C-index: 0.73). microvascular (MVI), macroinvasion, and poorly differentiation were associated with ATR.

Conclusions:

ATR is an independent risk factor for prognosis in HCC patients undergoing surgery and associated with MVI, macroinvasion, and poorly differentiation.


 Citation

Please cite as:

Mo S, He Y, Liang T, Zhu G, Su H, Chuangye Han C, Peng T

Serum Alpha-Fetoprotein-Tumor Size Ratio as a Prognostic Marker After Hepatic Resection for Primary Hepatocellular Carcinoma: Propensity Score Matched Retrospective Cohort Study

JMIR Cancer 2025;11:e64929

DOI: 10.2196/64929

PMID: 40857604

PMCID: 12380365

Per the author's request the PDF is not available.

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