To evaluate the prognostic value of AST/Plt ratio index (APRI) for hepatocellular carcinoma (HCC) patients with lymph node metastasis (LNM) after surgery.

Clinical data of 111 HCC patients who underwent hepatectomy combined with lymph node dissection in Tongji Hospital Affiliated to Huazhong University of Science and Technology from January 2012 to January 2017 were retrospectively analyzed. Among them, 96 patients were male and 15 female, aged (50±12) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients were divided into the LNM and non-LMN (NLNM) groups according to the presence of LNM or not. Survival curve was delineated by Kaplan-Meier survival curve. Survival analysis between two groups was compared by Log-rank test. The prognostic factors for HCC with LNM patients were identified by Cox's proportional hazards model.

The incidence of LNM in HCC patients was 15.3%(17/111). In the LNM and NLNM groups, the median survival of patients was 7.2 and 29.2 months, and the 1-, 3-, 5-year overall survival rates were 44.61%, 18.35%, 5.20%, and 76.75%, 44.01%,13.85%, respectively. The overall survival rate in the LNM group was significantly lower than that in the NLNM group (χ2=4.831, P<0.05). Multivariate Cox's analysis showed that APRI>0.38, Plt>3.15×109/L, HBcAb(+), DB>9.2 μmol/L and spleen thickness>3.6 cm were the independent risk factors for the overall survival of HCC patients after hepatectomy combined with lymph node dissection (HR=2.085, 12.271, 3.315, 16.830, 2.468; P<0.05).

Clinical prognosis of HCC patients with LNM is poor. APRI is an independent prognostic factor for HCC patients after hepatectomy combined with lymph node dissection.