title: Stratified aspartate aminotransferase-to-platelet ratio index accurately predicts survival in hepatocellular carcinoma patients undergoing curative liver resection.
abstract: The aspartate aminotransferase-to-platelet ratio index has been reported to predict prognosis of patients with hepatocellular carcinoma. This study examined the prognostic potential of stratified aspartate aminotransferase-to-platelet ratio index for hepatocellular carcinoma patients undergoing curative liver resection. A total of 661 hepatocellular carcinoma patients were retrieved and the associations between aspartate aminotransferase-to-platelet ratio index and clinicopathological variables and survivals (overall survival and disease-free survival) were analyzed. Higher aspartate aminotransferase-to-platelet ratio index quartiles were significantly associated with poorer overall survival (p = 0.002) and disease-free survival (p = 0.001). Multivariate analysis showed aspartate aminotransferase-to-platelet ratio index to be an independent risk factor for overall survival (p = 0.018) and disease-free survival (p = 0.01). Patients in the highest aspartate aminotransferase-to-platelet ratio index quartile were at 44% greater risk of death than patients in the first quartile (hazard ratio = 1.445, 95% confidence interval = 1.081 - 1.931, p = 0.013), as well as 49% greater risk of recurrence (hazard ratio = 1.49, 95% confidence interval = 1.112-1.998, p = 0.008). Subgroup analysis also showed aspartate aminotransferase-to-platelet ratio index to be an independent predictor of poor overall survival and disease-free survival in patients positive for hepatitis B surface antigen or with cirrhosis (both p < 0.05). Similar results were obtained when aspartate aminotransferase-to-platelet ratio index was analyzed as a dichotomous variable with cutoff values of 0.25 and 0.62. Elevated preoperative aspartate aminotransferase-to-platelet ratio index may be independently associated with poor overall survival and disease-free survival in hepatocellular carcinoma patients following curative resection.
authors.affiliation: 1 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.|2 Department of General Surgery, First People's Hospital of Changde, Changde, China.
authors.forename: Hao-Jie
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: 1 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.|3 Department of General Surgery, Second People's Hospital of Jingmen, Jingmen, China.
authors.forename: Jing-Hang
authors.initials: JH
authors.lastname: Jiang
authors.affiliation: 4 Department of Chemotherapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Yang
authors.affiliation: 5 Department of Thyroid and Breast Surgery, Central Hospital of Wuhan, Wuhan, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Guo
authors.affiliation: 6 Guangxi Medical University, Nanning, China.
authors.forename: Ji-Jia
authors.initials: JJ
authors.lastname: Li
authors.affiliation: 6 Guangxi Medical University, Nanning, China.
authors.forename: Xuan-Han
authors.initials: XH
authors.lastname: Liu
authors.affiliation: 6 Guangxi Medical University, Nanning, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Lu
authors.affiliation: 2 Department of General Surgery, First People's Hospital of Changde, Changde, China.
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Zeng
authors.affiliation: 2 Department of General Surgery, First People's Hospital of Changde, Changde, China.
authors.forename: Jin-Song
authors.initials: JS
authors.lastname: Ye
authors.affiliation: 2 Department of General Surgery, First People's Hospital of Changde, Changde, China.
authors.forename: Ke-Lan
authors.initials: KL
authors.lastname: Zhang
authors.affiliation: 2 Department of General Surgery, First People's Hospital of Changde, Changde, China.
authors.forename: Neng-Zhi
authors.initials: NZ
authors.lastname: Chen
authors.affiliation: 1 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Bang-De
authors.initials: BD
authors.lastname: Xiang
authors.affiliation: 1 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood*; D001792:Blood Platelets / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D001219:Aspartate Aminotransferases
keywords: Aspartate aminotransferase-to-platelet ratio index; curative liver resection; hepatocellular carcinoma; overall survival; recurrence