Usefulness of a new inflammation-based scoring system for prognostication of patients with hepatocellular carcinoma after hepatectomy

Abstract Background We investigated whether a preoperative scoring system (the “CRP-AFP Score [CAS]”) based on the serum levels of C-reactive protein and alpha-fetoprotein would predict outcome in patients undergoing hepatectomy for hepatocellular carcinoma. Methods The CAS was defined as follows: patients with an elevated level of both C-reactive protein (>.3 mg/dL) and alpha-fetoprotein (>20 ng/mL) were assigned a score of 2, and patients showing one or none of these abnormalities were assigned a score of 1 or 0, respectively. Results A total of 349 patients were identified. Pathologic findings, in terms of tumor size, histologic grade, vascular invasion, intrahepatic metastasis, and recurrence rate, worsened as the CAS increased. CAS 2 patients had a poorer 5-year overall survival than CAS 0 or 1 patients (32.2% vs 59.7% vs 49.2%, respectively; P < .001). Conclusions The CAS is an informative scoring system that can predict outcome in patients with hepatocellular carcinoma after hepatectomy.