title: Usefulness of a new inflammation-based scoring system for prognostication of patients with hepatocellular carcinoma after hepatectomy.
abstract: BACKGROUND
  We investigated whether a preoperative scoring system (the "CRP-AFP Score [CAS]") based on the serum levels of C-reactive protein and alpha-fetoprotein would predict outcome in patients undergoing hepatectomy for hepatocellular carcinoma.
  
  
  METHODS
  The CAS was defined as follows: patients with an elevated level of both C-reactive protein (>.3 mg/dL) and alpha-fetoprotein (>20 ng/mL) were assigned a score of 2, and patients showing one or none of these abnormalities were assigned a score of 1 or 0, respectively.
  
  
  RESULTS
  A total of 349 patients were identified. Pathologic findings, in terms of tumor size, histologic grade, vascular invasion, intrahepatic metastasis, and recurrence rate, worsened as the CAS increased. CAS 2 patients had a poorer 5-year overall survival than CAS 0 or 1 patients (32.2% vs 59.7% vs 49.2%, respectively; P < .001).
  
  
  CONCLUSIONS
  The CAS is an informative scoring system that can predict outcome in patients with hepatocellular carcinoma after hepatectomy.
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan. Electronic address: s-mori@dokkyomed.ac.jp.
authors.forename: Shozo
authors.initials: S
authors.lastname: Mori
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Kita
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
authors.forename: Mitsugi
authors.initials: M
authors.lastname: Shimoda
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D003661:Decision Support Techniques; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; D002097:C-Reactive Protein
keywords: Inflammation; Liver resection; Liver transplantation; Recurrence; Tumor marker