The value of preoperative systemic inflammatory response index (SIRI) combined with albumin-bilirubin grading (ALBI) in predicting early recurrence following curative resection of single hepatocellular carcinoma

Background: This study was conducted to explore the risk factors for early recurrence of single hepatocellular carcinoma (HCC) following curative resection, and to evaluate the predictive value of systemic inflammatory response index (SIRI) combined with the albumin - bilirubin index (ALBI) for early recurrence of HCC following curative resection. Methods We retrospectively analyzed the clinical data of 233 patients with pathologically confirmed HCC who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2018. The optimal cut-off values of alpha-fetoprotein, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), SIRI, and ALBI were determined by receiver operating characteristic curve (ROC), and the predictive efficiency of each index was compared by area under curve (AUC). A Cox-proportional hazard regression model was used to analyze factors affecting early recurrence. Kaplan-Meier analysis was used to estimate the 2-year recurrence-free survival (RFS) rate of different factors. Results The AUC of SIRI for predicting early recurrence was 0.644, which was better than that of NLR, MLR, PLR, and SII. SIRI > 0.96, ALBI >-2.7, tumor diameter > 5 cm, and microvascular invasion (MVI) were risk factors for early recurrence after radical resection of HCC. The AUC of SIRI combined with ALBI was 0.759, which was better than that of single SIRI and ALBI. Combined with the above four risk factors, a new prognostic index was constructed, and the AUC for predicting early recurrence was 0.801. Conclusion SIRI, ALBI, MVI, and tumor diameter could be considered reliable predictors of early recurrence following curative resection of single HCC. Preoperative SIRI combined with ALBI possesses an important reference value in predicting early recurrence following radical resection of HCC. It is helpful for clinicians in identifying high-risk patients with early recurrence, actively carry out postoperative adjuvant treatment, and improving the prognosis of patients.