Case Control Study
Copyright ©The Author(s) 2024.
World J Gastrointest Oncol. Dec 15, 2024; 16(12): 4579-4596
Published online Dec 15, 2024. doi: 10.4251/wjgo.v16.i12.4579
Table 1 Preoperative clinicopathologic data of patients with solitary hepatitis B virus-related hepatocellular carcinoma
Variables
N (1167)
Before PSM
P value
N (656)
After PSM
P value
GPR ≤ 0.2 (n = 381)
GPR > 0.2 (n = 786)
GPR ≤ 0.2 (n = 328)
GPR > 0.2 (n = 328)
SexMale985278707< 0.0015332662671
Female182103791236261
Age (years)≤ 506542294250.0593771961810.269
> 50513152361279132147
Body mass index> 243541242300.282205107980.5
≤ 24813257556451221230
SmokingYes407100307< 0.00119097930.796
No760281479466231235
DrinkingYes38689297< 0.00117987920.726
No781292489477241236
Diabetes mellitusYes5915440.2843315180.721
No1108366742623313310
HypertensionYes11438760.9536733341
No1053343710589295294
Family history of liver cancerYes12841870.9547239330.532
No1039340699584289295
Liver flukesYes221531680.00311251610.35
No946328618544277267
CirrhosisYes587158429< 0.0012801451350.477
No580223357376183193
Serum alpha-fetoprotein (ng/mL)≥ 2004401642760.0112461391070.012
< 200727217510410189221
Child-PughA11513787730.3556493253241
B16313734
Barcelona Clinic Liver Cancer stage0172651070.14210353500.83
A995316679553275278
Total bilirubin (μmol/L)> 20.512831970.047328450.047
≤ 20.51039350689583300283
Albumin (g/L)> 40534223311< 0.0013541841700.309
≤ 40633158475302144158
Gamma-glutamyl transpeptidase (U/L)> 5055718539< 0.00122118203< 0.001
≤ 50610363247435310125
Hepatitis B virus DNA (IU/mL)> 10005211433780.0012771261510.058
≤ 1000646238408379202177
HBeAg status-2996199180.9142592525110.510
+821672496976145
Antiviral therapyNo2655217860.2642332214540.310
Yes11626538195107202
Surgical margin (cm)< 21693084770.0921461272730.132
≥ 2212478690182201383
Tumor size (cm)> 5444113331< 0.0012081031050.933
≤ 5723268455448225223
Microvascular invasionYes301862150.09315279730.644
No866295571504249255
Infiltrative growthYes4381662720.0042701371330.812
No729215514386191195
Table 2 Univariate and multivariate Cox-regression analyses predicting overall survival before and after propensity score matching
VariablesBefore propensity matching
After propensity matching
Uni-HR (95%CI)
P value
Multi-HR (95%CI)
P value
Uni-HR (95%CI)
P value
Multi-HR (95%CI)
P value
Sex (male/female)1.44 (1.01-2.05)0.0431.3 (0.9-1.87)0.1591.22 (0.79-1.87)0.364
Age (years) (> 50/≤ 50)1.02 (0.81-1.29)0.850.86 (0.63-1.19)0.362
Body mass index (> 24/≤ 24)1.16 (0.9-1.49)0.2551.25 (0.88-1.79)0.218
Smoking (yes/no)1.05 (0.83-1.34)0.6721.04 (0.74-1.48)0.81
Drinking (yes/no)0.9 (0.7-1.15)0.4120.85 (0.59-1.23)0.388
Diabetes mellitus (yes/no)0.75 (0.4-1.41)0.3720.46 (0.15-1.45)0.186
Hypertension (yes/no)0.82 (0.54-1.24)0.3450.66 (0.36-1.23)0.192
Family cases (yes/no)0.79 (0.53-1.17)0.2340.61 (0.34-1.1)0.098
Liver flukes (yes/no)0.88 (0.65-1.19)0.3920.75 (0.47-1.18)0.214
Cirrhosis (yes/no)1.21 (0.96-1.53)0.11.24 (0.9-1.71)0.18
Child-Pugh (B/A)2.16 (1.07-4.36)0.0321.78 (0.87-3.63)0.1151.34 (0.33-5.42)0.679
Barcelona Clinic Liver Cancer stage (A/0)1.93 (1.31-2.83)< 0.0011.51 (1-2.26)0.0482.03 (1.19-3.45)0.0091.64 (0.94-2.86)0.082
Total bilirubin (μmol/L) (> 20.5/≤ 20.5)0.85 (0.6-1.21)0.370.9 (0.55-1.45)0.651
Albumin (g/L) (> 40/≤ 40)1.35 (1.07-1.71)0.0121.16 (0.91-1.48)0.2291.2 (0.87-1.65)0.26
Alpha-fetoprotein (ng/mL) (≥ 200/< 200)1.38 (1.09-1.74)0.0061.35 (1.06-1.72)0.0131.37 (0.99-1.89)0.055
Hepatitis B virus DNA (IU/mL) (> 1000/≤ 1000)0.73 (0.58-0.92)0.0080.83 (0.66-1.05)0.1230.72 (0.52-0.99)0.0420.82 (0.59-1.12)0.213
Tumor size (cm) (≤ 5/> 5)0.57 (0.46-0.72)< 0.0010.74 (0.57-0.95)0.0190.6 (0.43-0.82)0.0020.66 (0.48-0.93)0.017
Microvascular invasion (yes/no)1.55 (1.21-1.99)< 0.0011.19 (0.92-1.55)0.1861.2 (0.83-1.74)0.322
Infiltrative growth (yes/no)1.29 (1.02-1.63)0.0321.35 (1.06-1.7)0.0141.2 (0.87-1.65)0.272
Gamma-glutamyl transpeptidase-to-platelet ratio
(≤ 0.2/> 0.2)
0.48 (0.36-0.64)< 0.0010.52 (0.39-0.69)< 0.0010.49 (0.35-0.69)< 0.0010.5 (0.36-0.7)< 0.001
Table 3 Univariate and multivariate Cox-regression analyses predicting recurrence-free survival before and after propensity score matching
Variables
Before propensity matching
After propensity matching
Uni-HR (95%CI)
P value
Multi-HR (95%CI)
P value
Uni-HR (95%CI)
P value
Multi-HR (95%CI)
P value
Sex (male/female)1.32 (1.03-1.69)0.0281.19 (0.92-1.54)0.1761.09 (0.8-1.49)0.574
Age (years) (> 50/≤ 50)1.03 (0.87-1.22)0.7560.93 (0.73-1.19)0.575
Body mass index (> 24/≤ 24)1.13 (0.94-1.36)0.1851 (0.77-1.29)0.989
Smoking (yes/no)1.11 (0.93-1.32)0.2441.01 (0.78-1.31)0.93
Drinking (yes/no)1 (0.84-1.2)0.9720.85 (0.64-1.11)0.23
Diabetes mellitus (yes/no)1.4 (0.98-2)0.0671.22 (0.71-2.1)0.461
Hypertension (yes/no)0.81 (0.6-1.09)0.1650.83 (0.54-1.26)0.38
Family cases (yes/no)0.89 (0.68-1.16)0.3840.76 (0.51-1.14)0.192
Liver flukes (yes/no)1.14 (0.93-1.4)0.2041.01 (0.74-1.38)0.945
Cirrhosis (yes/no)1.27 (1.08-1.5)0.0051.25 (1.05-1.49)0.0121.3 (1.03-1.65)0.031.33 (1.04-1.68)0.021
Child-Pugh (B/A)1.08 (0.54-2.18)0.8231.01 (0.32-3.14)0.99
Barcelona Clinic Liver Cancer stage (A/0)1.4 (1.09-1.8)0.0081.14 (0.87-1.49)0.3481.39 (0.98-1.97)0.061
Total bilirubin (μmol/L) (> 20.5/≤ 20.5)0.87 (0.67-1.13)0.2920.85 (0.6-1.22)0.386
Albumin (g/L) (> 40/≤ 40)1.36 (1.15-1.61)< 0.0011.17 (0.98-1.4)0.0841.21 (0.96-1.54)0.112
Alpha-fetoprotein (ng/mL) (≥ 200/< 200)1.31 (1.1-1.55)0.0021.29 (1.08-1.54)0.0051.22 (0.96-1.55)0.111
Hepatitis B virus DNA (IU/mL) (> 1000/≤ 1000)0.8 (0.68-0.95)0.0090.9 (0.76-1.06)0.2140.76 (0.6-0.96)0.0230.8 (0.63-1.02)0.067
Tumor size (cm) (≤ 5/> 5)0.6 (0.51-0.71)< 0.0010.67 (0.55-0.81)< 0.0010.79 (0.62-1.02)0.07
Microvascular invasion (yes/no)1.4 (1.16-1.68)< 0.0011.1 (0.9-1.33)0.3591.18 (0.9-1.56)0.233
Infiltrative growth (yes/no)1.24 (1.05-1.47)0.0131.28 (1.08-1.53)0.0051.24 (0.97-1.57)0.082
Gamma-glutamyl transpeptidase-to-platelet ratio (≤ 0.2/> 0.2)0.49 (0.4-0.6)< 0.0010.53 (0.43-0.65)< 0.0010.56 (0.44-0.71)< 0.0010.57 (0.44-0.73)< 0.001
Table 4 Stratified analysis between gamma-glutamyl transpeptidase-to-platelet ratio levels and prognosis in the solitary hepatitis B virus-related hepatocellular carcinoma
VariablesBefore propensity matching
After propensity matching
OS-HR (95%CI)
P value
RFS-HR (95%CI)
P value
OS-HR (95%CI)
P value
RFS-HR (95%CI)
P value
As continuous1.12 (1.04-1.20)0.0021.11 (1.06-1.17)< 0.0011.29 (1.18-1.42)< 0.0011.20 (1.11-1.31)< 0.001
By GPR cut-off
GPR ≤ 0.2
GPR > 0.22.07 (1.56-2.74)< 0.0012.05 (1.68-2.51)< 0.0012.04 (1.46-2.84)< 0.0011.79 (1.40-2.28)< 0.001
By GPR tercile
Bottom (≤ 0.2)
Middle (> 0.2, ≤ 0.6)1.81 (1.35-2.44)< 0.0011.85 (1.50-2.29)< 0.0011.52 (1.08-2.14)0.0171.69 (1.25-2.17)< 0.001
Top (> 0.6)2.74 (1.98-3.81)< 0.0012.60 (2.04-3.31)< 0.0012.33 (1.60-3.39)< 0.0012.35 (1.77-3.13)< 0.001
P for trend1< 0.001< 0.001< 0.001< 0.001
By interquartile
Q1
Q21.42 (0.98-2.06)0.0611.43 (1.10-1.86)< 0.0010.75 (0.43-1.28)0.2880.88 (0.60-1.29)0.514
Q31.72 (1.20-2.46)0.0031.74 (1.35-2.24)< 0.0011.45 (0.90-2.34)0.1251.58 (1.12-2.23)0.009
Q42.34 (1.66-3.29)< 0.0012.29 (1.79-2.93)< 0.0012.08 (1.33-3.24)0.0011.79 (1.27-2.51)0.001
P for trend1< 0.001< 0.001< 0.001< 0.001