Examination of the modified Glasgow Prognostic Score and other prognostic factors in patients undergoing hepatectomy for naïve hepatocellular carcinoma: A retrospective observational study

Aim: To identify prognostic factors in patients undergoing hepatectomy for hepatocellular carcinoma (HCC), including the modified Glasgow Prognostic Score (mGPS) with a C-reactive protein (CRP) cutoff value of 0.5 mg/dl. Methods: All study participants underwent hepatectomy for naïve HCC at Kindai University Hospital between January 2004 and December 2013. Their medical records were reviewed retrospectively to identify prognostic factors including the mGPS. Patients with elevated CRP levels (>0.5 mg/dl) and hypoalbuminemia (<3.5 g/dl) were assigned an mGPS score of 2 (mGPS2), those with one of these factors were allocated a score of 1 (mGPS1) and patients with neither factor were allocated a score of 0 (mGPS0). The patients were then divided into an mGPS1–2 group (including mGPS1 and mGPS2; n = 51) and an mGPS0 group (n = 150). Results: There were significant differences between the groups regarding tumor diameter, PIVKA-II expression, microvascular invasion, and TNM stage. Kaplan–Meier analysis revealed that patients in the mGPS1–2 group had a significantly poorer prognosis in terms of overall survival and disease-free survival than those in the mGPS0 group. In a multivariate analysis using the Cox proportional hazards model, TNM stage and mGPS were independent prognostic factors for disease-free survival, while alphafetoprotein level, intraoperative blood loss, and mGPS were independent prognostic factors for overall survival. Conclusion: Tumor-related factors, intraoperative blood loss, and mGPS are important prognostic factors in patients who have been treated surgically for HCC. An mGPS with a CRP cutoff value of 0.5 mg/dl is a useful prognostic factor.departmental bulletin pape