FIB-4 Index for Assessing the Prognosis of Hepatocellular Carcinoma in Patients with Child-Pugh Class A Liver Function

Overview

Journal J Cancer Res Clin Oncol

Specialty Oncology

Date 2015 Feb 5

PMID 25648362

Citations 7

Authors

Takanori Ito

Takashi Kumada

Hidenori Toyoda

Toshifumi Tada

Affiliations

Soon will be listed here.

Abstract

Purpose: We evaluated the prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh (C-P) class A based on FIB-4 index, which is a liver fibrosis marker.

Patients And Methods: A total of 915 HCC patients with C-P class A were investigated. We assessed the prognosis using FIB-4 index, and factors associated with survival rates were analyzed in these patients.

Results: When patients were categorized according to FIB-4 index as <2.0 (n = 93), ≥ 2.0 and <4.0 (n = 311), and ≥ 4.0 (n = 511), survival rates at 5 years were 70.5% [95% confidence interval (CI) 59.0-79.9], 56.4% (95% CI 50.1-62.5), and 47.1% (95% CI 42.2-52.1), respectively. Patients with FIB-4 index <2.0 had a higher survival rate than the other groups (≥ 4.0 vs ≥ 2.0 and <4.0, p = 0.010; ≥ 2.0 and <4.0 vs <2.0, p = 0.028). We were able to predict prognosis in patients with C-P score 5 by FIB-4 index, but survival rate did not significantly differ in patients with C-P score 6. Multivariate analysis identified C-P score, FIB-4 index [≥ 2.0 and <4.0; hazard ratios (HRs) 1.638 (95% CI 1.084-2.474); p = 0.019/≥ 4.0; HR 1.828 (95% CI 1.217-2.744); p = 0.004], Lens culinaris agglutinin-reactive α-fetoprotein, tumor size, number, vascular invasion, antiviral therapy, and hepatectomy as independent predictive factors for survival.

Conclusions: The FIB-4 index is useful for assessing prognosis in HCC patients with C-P class A, especially those with C-P score 5.

Citing Articles

Clinical Significance of Fibrosis 4 Index in Early-stage Hepatocellular Carcinoma Patients Received Ultrasound-guided Microwave Ablation.

Chen J, Jiang X, Chen Y, Tang H, Zhang Y, Lu Y Appl Biochem Biotechnol. 2024; .

PMID: 39601976 DOI: 10.1007/s12010-024-05108-w.

A novel combined C-reactive protein-albumin ratio and modified albumin-bilirubin score can predict long-term outcomes in patients with hepatocellular carcinoma after hepatic resection.

Aida T, Haruki K, Akaoka M, Furukawa K, Onda S, Shirai Y Ann Gastroenterol Surg. 2024; 8(1):143-150.

PMID: 38250682 PMC: 10797842. DOI: 10.1002/ags3.12727.

Association between reactive oxygen species production in neutrophils and liver fibrosis in the general population.

Sato S, Nakaji S, Sawada K, Akimoto N, Tateda T, Kaizuka M J Clin Biochem Nutr. 2023; 73(3):214-220.

PMID: 37970548 PMC: 10636577. DOI: 10.3164/jcbn.23-46.

Effect of Liver Fibrosis on Oral and Gut Microbiota in the Japanese General Population Determined by Evaluating the FibroScan-Aspartate Aminotransferase Score.

Sato S, Iino C, Chinda D, Sasada T, Tateda T, Kaizuka M Int J Mol Sci. 2023; 24(17).

PMID: 37686272 PMC: 10487682. DOI: 10.3390/ijms241713470.

Comparison of FIB-4 Index and Child-Pugh Score in Predicting the Outcome of Hepatic Resection for Hepatocellular Carcinoma.

Zhou P, Chen B, Miao X, Zhou J, Xiong L, Wen Y J Gastrointest Surg. 2019; 24(4):823-831.

PMID: 31066014 DOI: 10.1007/s11605-019-04123-1.

References

Afdhal N, Reddy K, Nelson D, Lawitz E, Gordon S, Schiff E . Ledipasvir and sofosbuvir for previously treated HCV genotype 1 infection. N Engl J Med. 2014; 370(16):1483-93. DOI: 10.1056/NEJMoa1316366. View

Kudo M, Chung H, Haji S, Osaki Y, Oka H, Seki T . Validation of a new prognostic staging system for hepatocellular carcinoma: the JIS score compared with the CLIP score. Hepatology. 2004; 40(6):1396-405. DOI: 10.1002/hep.20486. View

Kumada T, Toyoda H, Kiriyama S, Tanikawa M, Hisanaga Y, Kanamori A . Characteristics of elderly hepatitis C virus-associated hepatocellular carcinoma patients. J Gastroenterol Hepatol. 2012; 28(2):357-64. DOI: 10.1111/jgh.12057. View

Toyoda H, Kumada T, Tada T, Sone Y, Kaneoka Y, Maeda A . Characteristics and prognosis of patients with hepatocellular carcinoma after the year 2000 in Japan. J Gastroenterol Hepatol. 2011; 26(12):1765-71. DOI: 10.1111/j.1440-1746.2011.06789.x. View

Llovet J, Bru C, Bruix J . Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999; 19(3):329-38. DOI: 10.1055/s-2007-1007122. View

Fernandez-Esparrach G, Sanchez-Fueyo A, Gines P, Uriz J, Quinto L, Ventura P . A prognostic model for predicting survival in cirrhosis with ascites. J Hepatol. 2001; 34(1):46-52. DOI: 10.1016/s0168-8278(00)00011-8. View

Rodriguez de Lope C, Tremosini S, Forner A, Reig M, Bruix J . Management of HCC. J Hepatol. 2012; 56 Suppl 1:S75-87. DOI: 10.1016/S0168-8278(12)60009-9. View

Buster E, Hansen B, Buti M, Delwaide J, Niederau C, Michielsen P . Peginterferon alpha-2b is safe and effective in HBeAg-positive chronic hepatitis B patients with advanced fibrosis. Hepatology. 2007; 46(2):388-94. DOI: 10.1002/hep.21723. View

Jacobson I, Gordon S, Kowdley K, Yoshida E, Rodriguez-Torres M, Sulkowski M . Sofosbuvir for hepatitis C genotype 2 or 3 in patients without treatment options. N Engl J Med. 2013; 368(20):1867-77. DOI: 10.1056/NEJMoa1214854. View

10.

Izumi R, Shimizu K, Ii T, Yagi M, Matsui O, Nonomura A . Prognostic factors of hepatocellular carcinoma in patients undergoing hepatic resection. Gastroenterology. 1994; 106(3):720-7. DOI: 10.1016/0016-5085(94)90707-2. View

11.

Sterling R, Lissen E, Clumeck N, Sola R, Correa M, Montaner J . Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006; 43(6):1317-25. DOI: 10.1002/hep.21178. View

12.

Afdhal N, Zeuzem S, Kwo P, Chojkier M, Gitlin N, Puoti M . Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Engl J Med. 2014; 370(20):1889-98. DOI: 10.1056/NEJMoa1402454. View

13.

Wai C, Greenson J, Fontana R, Kalbfleisch J, Marrero J, Conjeevaram H . A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003; 38(2):518-26. DOI: 10.1053/jhep.2003.50346. View

14.

Shah A, Lydecker A, Murray K, Tetri B, Contos M, Sanyal A . Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009; 7(10):1104-12. PMC: 3079239. DOI: 10.1016/j.cgh.2009.05.033. View

15.

Lok A, Gardiner D, Lawitz E, Martorell C, Everson G, Ghalib R . Preliminary study of two antiviral agents for hepatitis C genotype 1. N Engl J Med. 2012; 366(3):216-24. DOI: 10.1056/NEJMoa1104430. View

16.

Shim J, Lee H, Kim K, Lim Y, Chung Y, Lee Y . Efficacy of entecavir in treatment-naïve patients with hepatitis B virus-related decompensated cirrhosis. J Hepatol. 2009; 52(2):176-82. DOI: 10.1016/j.jhep.2009.11.007. View

17.

Tamaki N, Kurosaki M, Matsuda S, Muraoka M, Yasui Y, Suzuki S . Non-invasive prediction of hepatocellular carcinoma development using serum fibrosis marker in chronic hepatitis C patients. J Gastroenterol. 2013; 49(11):1495-503. DOI: 10.1007/s00535-013-0914-y. View

18.

Pugh R, Murray-Lyon I, Dawson J, Pietroni M, Williams R . Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973; 60(8):646-9. DOI: 10.1002/bjs.1800600817. View

19.

Leroy V, Hilleret M, Sturm N, Trocme C, Renversez J, Faure P . Prospective comparison of six non-invasive scores for the diagnosis of liver fibrosis in chronic hepatitis C. J Hepatol. 2007; 46(5):775-82. DOI: 10.1016/j.jhep.2006.12.013. View

20.

Merkel C, Bolognesi M, Sacerdoti D, Bombonato G, Bellini B, Bighin R . The hemodynamic response to medical treatment of portal hypertension as a predictor of clinical effectiveness in the primary prophylaxis of variceal bleeding in cirrhosis. Hepatology. 2000; 32(5):930-4. DOI: 10.1053/jhep.2000.19322. View