Serum Sorbitol Dehydrogenase as a Novel Prognostic Factor for Hepatocellular Carcinoma after Surgical Resection

Simple Summary A large percentage of patients with hepatocellular carcinoma (HCC) who undergo surgical resection experience a recurrence of their disease. Therefore, predicting recurrence after resection for HCC is crucial to select appropriate surgical candidates. The aim of this study was to determine if serum sorbitol dehydrogenase (SORD) levels, an enzyme that reflects liver damage, was associated with the length of recurrence-free survival. This study's findings that serum SORD levels >= 15 ng/mL were associated with a shorter recurrence-free survival might help to determine which patients are better candidates for surgery in HCC. Moreover, baseline serum SORD and alpha-fetoprotein (AFP) levels could better predict the outcome when used in combination, with patients having both elevated SORD (>= 15 ng/mL) and AFP (>= 400 ng/mL) levels having a particularly poor prognosis. Therefore, incorporating serum SORD along with AFP levels in clinical practice may raise predictability of prognosis in HCC patients. The majority of patients with hepatocellular carcinoma (HCC) undergoing curative resection experience tumor recurrence. To examine the association between preoperative serum sorbitol dehydrogenase (SORD), a liver-derived enzyme that reflects liver damage, and recurrence of HCC after curative resection, 92 patients were randomly selected who underwent curative resection for HCC between 2011 and 2012 from a prospective registry. Recurrence-free survival (RFS) was compared based on serum SORD levels. Cox proportional hazard models were used to investigate prognostic factors for RFS. During a median follow-up duration of 57.1 months, 43 patients experienced HCC recurrence. Patients with serum SORD >= 15 ng/mL (HR, 3.46; 95% CI, 1.76-6.81; p < 0.001) had worse RFS compared with patients with serum SORD = 400 ng/mL and serum SORD levels >= 15 ng/mL had a distinctly poor prognosis with the lowest RFS rates (HR, 22.08; 95% CI, 6.91-70.50; p < 0.001). Baseline serum SORD is an effective prognostic factor for HCC after resection. It may help guide patient selection for surgery, especially when combined with serum AFP levels.