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Unlocking Prognostic Potential: Serum Uric Acid and Prothrombin Time as Predictors of HCC Recurrence
Background:
This study aims to explore the prognostic value of pre-treatment serum uric acid (UA) and prothrombin time (PT) levels on the risk of tumor recurrence in patients with hepatocellular carcinoma (HCC) after receiving comprehensive therapy.
Methods:
A total of 199 HCC patients who underwent combination therapy (including surgical resection, local ablation, interventional therapy, and systemic therapy) at Fujian Cancer Hospital from January 2020 to December 2022 were consecutively enrolled. Baseline clinical data and pre-treatment laboratory indicators were collected. The primary endpoint was recurrence-free survival (RFS), with a median follow-up time of 19 months. The optimal cutoff values for UA and PT of predicting recurrence were determined using receiver operating characteristic (ROC) curves. Independent risk factors affecting RFS were analyzed using the Cox proportional hazards regression model. The Kaplan-Meier method was used to plot survival curves to compare differences between groups and to construct nomograms. Spearman's correlation analysis was also conducted.
Results:
A total of 116 patients (58.3%) experienced recurrence. Multivariate Cox regression analysis showed that UA (HR = 1.486, 95% CI: 1.009 - 2.189, p = 0.045) and PT (HR = 1.510, 95% CI: 1.011 - 2.261, p = 0.046) were independent risk factors for HCC recurrence. Furthermore, based on optimal cutoff values determined by ROC curve analysis, Kaplan-Meier survival analysis confirmed that recurrence-free survival (RFS) was significantly lower in the low-UA group and short-PT group (p < 0.05). Correlation analysis indicated that UA and PT had no significant correlation with alpha-fetoprotein (AFP), a traditional tumor marker for HCC, with p > 0.05, suggesting that their prognostic information is independent of traditional tumor markers.
Conclusions:
Elevated pre-treatment serum uric acid (UA) levels and prolonged prothrombin time (PT) are independent predictive factors for recurrence after combined therapy in HCC patients. These two indicators, as routine and easily accessible clinical tests, are cost-effective and have significant potential for application in improving postoperative risk stratification, identifying high-risk patient groups, and guiding individualized follow-up strategies for HCC patients.
