Abstract
BACKGROUND: This study aimed to investigate the association between a new biomarker that incorporates albumin (Alb) and butyrylcholinesterase (BCHE) levels, as well as the prognosis of hepatocellular carcinoma (HCC) after hepatectomy. METHODS: The study enrolled 1712 patients who underwent primary hepatectomy for HCC between January 2003 and December 2019 at seven institutions belonging to the Hiroshima Surgical Study Group of Clinical Oncology. The entire dataset was randomly split into discovery and validation cohorts in a 7:3 ratio. The product of the preoperative Alb and BCHE levels was defined as the ABC. In the discovery cohort, the patients in the high-ABC group (≥ 951) were compared with those in the low-ABC group (< 951). These findings then were confirmed in the validation cohort. RESULTS: In the discovery cohort, a significant difference was observed in the 5-year survival rate between the high- and low-ABC groups (p < 0.001), and ABC was identified as an independent prognostic factor for HCC. Similarly, in the validation cohort, a significant difference was observed in the 5-year survival rate between the high- and low-ABC groups (p < 0.001), and ABC was identified as an independent prognostic factor for HCC. Furthermore, in the discovery and validation cohorts, significant differences in the early recurrence rate between the two groups were observed (p < 0.001 and p = 0.020, respectively). CONCLUSIONS: For patients with HCC, ABC is a useful predictive biomarker because it can be calculated in a simple manner and because it provides accurate prognostic information.