Prognostic impact of the HS-mGPS on patients undergoing radical surgery for hepatocellular carcinoma Authorship

Abstract Objiective: Our study aimed to assess the ability of High-Sensitivity modified Glasgow Prognostic Score (HS-mGPS) predicting survival in patients undergoing radical surgery for hepatocellular carcinoma (HCC) and to compare the impact with other Inflammation-Based Prognostic Scoring systems including Glasgow Prognostic Score (GPS) and modified GPS (mGPS). Methods: Our study evaluated 293 patients with HCC who had undergone hepatectomy at the Third Affiliated Hospital of Soochow University between 2010 and 2018. The HS-mGPS, mGPS, and GPS were calculated based on particular cut-off values of preoperative C-reactive protein and albumin, and the correlations between HS-mGPS and clinicopathological parameters were evaluated. Univariate and multivariate survival analyses were conducted by Kaplan–Meier method and Cox proportional hazards model. Result: Kaplan-Meier and univariate survival analyses demonstrated that higher scores of the HS-mGPS, GPS and mGPS were all associated with significantly lower overall survival (OS) (all p < 0.001). In multivariate survival analysis, the HS-mGPS ( p = 0.010) was an independent risk factor for poor OS in patients with HCC undergoing hepatectomy, along with the maximal tumor diameter ( p < 0.001), microvascular invasion(MVI)( p = 0.008), and BCLC stage( p = 0.001). Based on the receiver operating characteristic (ROC) curve and AUC (areas under the curve) values, HS-mGPS was superior to GPS and mGPS for predicting the long-term prognosis of patients with resectable HCC. Conclusion: Preoperative HS-mGPS is a superior prognostic score in predicting poor long-term outcomes after HCC patients undergoing radical surgery.