To explore the influencing factors of postoperative recurrence of hepatocellular carcinoma (HCC) after radical resection, and to establish its prediction model.

Clinical data of 210 patients with HCC who underwent radical resection in the Third Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2017 were retrospectively analyzed. Among them, 178 patients were male and 32 female, aged (51±11) years. The informed consents of all patients were obtained and the local ethical committee approval was received. The influencing factors of postoperative recurrence of HCC were analyzed by Cox univariate and multivariate analyses, and a clinical prediction model was established. The likelihood ratio test was carried out to evaluate the diagnostic efficiency of the established model.

Cox multivariate analysis showed that absolute neutrophils-to-lymphocytes ratio (NLR), absolute platelets-to-lymphocytes ratio (PLR), microvascular invasion, portal vein tumor thrombus, the maximum diameter of tumor, BCLC stage and postoperative TACE treatment were the independent influencing factors of postoperative recurrence of HCC (HR=1.228, 1.003, 1.822, 2.043, 1.009, 2.711, 0.233; P<0.05). Recurrent predictive index (PI)=0.205X1+0.003X2+0.600X3+0.714X4+0.009X5+0.168X6+0.997X7-1.455X8, where X1, X2, X3, X4, X5, X6, X7 and X8 represent NLR, PLR, microvascular invasion, portal vein tumor thrombus, the maximum diameter of tumor, BCLC B stage, BCLC C stage and postoperative TACE treatment. The greater the PI value, the higher the risk of recurrence. Significant differences were observed in the likelihood ratio test of prediction model (χ²=165.762, P<0.001).

Preoperative NLR, PLR, microvascular invasion, portal vein tumor thrombus, the maximum diameter of tumor, BCLC stage and postoperative TACE treatment are the independent influencing factors of HCC recurrence after radical resection. Postoperative TACE treatment contributes to preventing the postoperative recurrence. The prediction model yields high predictive efficiency.