AFP Model Predicts Outcomes After Liver Resection: A Multicenter Retrospective Cohort Study

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Transplant Hepatology

Background:

• The AFP model, integrating tumor factors and serum AFP, excels in predicting HCC recurrence post-liver transplant.
• Its prognostic performance after liver resection for HCC requires further definition.
• This study evaluates the AFP model's utility in predicting outcomes after curative hepatectomy.

Purpose of the Study:

• To assess the prognostic value of the AFP score for predicting recurrence and survival after liver resection for HCC.
• To validate the AFP model's performance in a contemporary French multicenter cohort undergoing curative hepatectomy.

Main Methods:

• Retrospective analysis of 424 adult patients undergoing curative HCC resection across five French centers (2012-2021).
• Patients were stratified by AFP score (≤ 2 vs. > 2).
• Survival outcomes (OS, RFS) analyzed using Kaplan-Meier and Cox regression.

Main Results:

• The AFP score was significantly associated with overall survival (OS) and recurrence-free survival (RFS) in univariable analysis.
• The AFP score independently predicted recurrence in multivariable analysis (HR 1.18, p=0.004).
• Patients with an AFP score > 2 exhibited significantly lower 24-month RFS (p=0.0005).

Conclusions:

• The AFP model demonstrates significant prognostic value for predicting HCC recurrence after liver resection.
• The AFP score can enhance preoperative risk stratification for patients undergoing hepatectomy.
• Integrating the AFP model may optimize postoperative surveillance and treatment strategies.