Tumor burden score combined with AFP and PIVKA-II (TAP score) to predict the prognosis of hepatocellular carcinoma patients after radical liver resection.

Background: Our study aimed to combine the morphological behavior (tumor burden score, TBS) and the biological behavior (AFP and PIVKA-II) to predict the prognosis of HCC patients after radical liver resection.

Methods: A total of 1766 HCC patients were divided into the training cohort (n = 1079) and the validation cohort (n = 687) with a ratio of 6:4. The Kaplan-Meier method was used to analyze the recurrence-free (RFS) and overall survival (OS). The multivariable Cox regression model was established based on the variables screened by the least absolute shrinkage and selection operator (LASSO) regression to identify variables independently associated with recurrence-free survival (RFS) and overall survival (OS). Constructing our prognostic score (TBS-LN(AFP + PIVKA-II) score, TAP score) based on regression coefficients and the predictive ability of the TAP score was compared with Barcelona Clinic Liver Cancer (BCLC) stage.

Results: The TAP score had good performance in stratifying RFS (p < 0.001) and OS (p < 0.001) in the training cohort and the validation cohort. There still existed significant differences in the intergroup comparisons among three TAP score groups for RFS and OS in the training cohort and the validation cohort. In our LASSO-Cox regression model, the TAP score was independently associated with RFS and OS. The TAP score also outperformed the BCLC stage in predicting RFS (1, 2 and 3 years) and OS (1, 3 and 5 years).

Conclusions: The TAP score had good performance in predicting the prognosis of HCC patients after radical liver resection and was superior to the BCLC stage.