Prognostic value of preoperative protein-induced vitamin K absence or antagonist II after liver resection for hepatitis B-related hepatocellular carcinoma: a nationwide multicenter study

• Published in: Annals of surgical treatment and research 2022-11, Vol.103 (5), p.271-279
• Main Authors: Byun, Dahn, Lee, Seul Gi, Kim, Hyeyoung, You, Yunghun, Jung, Jaehag, Jang, Je Ho, Lee, Moon-Soo, Kim, Chang-Nam, Cho, Byung Sun, Kang, Yoon-Jung
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2288-6575; 2288-6796
• DOI: 10.4174/astr.2022.103.5.271

PurposeAlthough protein-induced vitamin K absence or antagonist II (PIVKA-II) has been used as a diagnostic tool for hepatocellular carcinoma (HCC), its prognostic value remains unclear. MethodsThis was a nationwide multicenter study using the database of the Korean Liver Cancer Association. Patients with hepatitis B-related HCC who underwent liver resection as the first treatment after initial diagnosis (2008-2014) were selected randomly. Propensity score matching (1:1) was performed for comparative analysis between those with low and high preoperative PIVKA-II. Univariable and multivariable Cox proportional-hazards regression were used to identify prognostic factors for HCC-specific survival. ResultsAmong 6,770 patients, 956 patients were included in this study. After propensity score matching, the 2 groups (n = 245, each) were well balanced. The HCC-specific 5-year survival rate was 80.9% in the low PIVKA-II group and 78.7% in the high PIVKA-II group (P = 0.605). In univariable analysis, high PIVKA-II (>106.0 mAU/mL) was not a significant predictor for worse HCC-specific survival (hazard ratio [HR], 1.183; 95% confidence interval [CI], 0.76-1.85; P = 0.461). In multivariable analysis, hyponatremia of