Prognostic Value of Inflammatory Markers in HBV-Related HCC After Hepatectomy Based on a Clinical Database

Hepatitis B virus (HBV) remains an important risk factor for hepatocellular carcinoma (HCC), and inflammation plays an essential role in tumor development. This study aimed to investigate the impact of inflammatory markers in the postoperative outcomes of patients with HBV-related HCC, providing valuable prognostic indicators after hepatectomy. We retrospectively analyzed 222 patients with HBV-related HCC after surgical resection. The ROC curve was used to calculate biomarker cutoff values. The Kaplan–Meier method was used to estimate overall survival (OS) and recurrence-free survival (RFS), and univariate and multivariate analyses were used to identify the prognostic factors. The Kaplan–Meier analysis revealed that patients with high albumin-bilirubin (ALBI) score, aspartate aminotransferase to platelet ratio index (APRI), and monocyte to lymphocyte ratio (MLR) had worse OS, while those with high ALBI score and MLR had shorter RFS. Multivariate Cox regression analysis identified alpha-fetoprotein &gt;400 ng/mL (hazard ratio [HR]: 2.447, 95% confidence interval [CI]: 1.273–4.706, <i>p</i> = 0.007), alanine aminotransferase (HR: 0.377, 95% CI: 0.171–0.834, <i>p</i> = 0.016), platelet to lymphocyte ratio (HR: 0.385, 95% CI: 0.196–0.755, <i>p</i> = 0.006), systemic inflammatory response index (HR: 1.844, 95% CI: 1.049–3.239, <i>p</i> = 0.033), ALBI score (HR: 1.808, 95% CI: 1.020–3.203, <i>p</i> = 0.043), APRI score (HR: 3.193, 95% CI: 1.662–6.137, <i>p</i> &lt; 0.001), tumor diameter (HR: 1.083, 95% CI: 1.012–1.160, <i>p</i> = 0.022), and portal vein tumor thrombosis (PVTT) (HR: 6.083, 95% CI: 2.774–13.338, <i>p</i> &lt; 0.0001) as independent predictors for OS. MLR (HR: 2.285, 95% CI: 1.290–4.048, <i>p</i> = 0.005) and PVTT (HR: 2.672, 95% CI: 1.280–5.579, <i>p</i> = 0.009) were confirmed as significant prognostic markers of RFS in patients with HBV-related HCC. ALBI score, APRI, and MLR are effective prognostic predictors in patients with HBV-related HCC after curative resection. Close monitoring and adjuvant therapies should be considered for high-risk patients.