Wang et al developed a simple score for estimating the risk of recurrence for an HBV-related hepatocellular carcinoma following liver transplantation. The authors are from Sun Yat-Sen University and Provincial Key Laboratory of Liver Disease Research in Guangdong, China.
Patient selection: status post transplant for HBV-related hepatocellular carcinoma
Parameters:
(1) number of tumors
(2) macrovascular invasion
(3) neutrophil to lymphocyte ratio (NLR) prior to surgery
neutrophil-to-lymphocyte ratio = NLR =
= (absolute neutrophil count) / (absolute lymphocyte count) =
= (percent neutrophils in differential count) / (percent lymphocytes)
|
Parameter
|
Finding
|
Points
|
|
number of tumors
|
< 3
|
0
|
|
|
>= 3
|
1
|
|
macrovascular invasion
|
no
|
0
|
|
|
yes
|
1
|
|
NLR
|
< 3
|
0
|
|
|
>= 3
|
1
|
risk score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The higher the score the greater the risk of recurrence.
• Overall survival at 5-years for a score of 0 or 1 was 63% while very poor for a score of 2 or 3.
• A score of 3 was associated with recurrence within 6 months
Other risk factors from the univariate analysis:
(1) tumor size > 5 cm
(2) serum AFP >= 400 µg/L
(3) LOG10(HBV copies/mL) > 5 (> 100,000 copies per mL)
