Preoperative serum ferritin is an independent prognostic factor for liver cancer after hepatectomy

Background and aims: Serum ferritin (SF) may have a close relationship with the tumor. But no study has investigated the prognostic value of SF in hepatocellular carcinoma (HCC) patients receiving curative resection yet. Aim of this study is to explore the role of preoperative SF in survival outcomes of such patients. Methods: We retrospectively analyzed 427 HCC patients who received curative hepatic resection in our medical center. Significant clinical and pathological data along with the association between SF and clinicopathological parameters were compared and analyzed. The prognostic significance of SF was determined by Kaplan-Meier analysis and the Cox proportional hazards regression model. Results: The optimal cut-off value of SF for overall survival (OS) was 267 ng/ml. Preoperative SF level could predict OS (P = 0.001, HR = 1.651, 95%CI: 1.213-2.247) and recurrence-free survival (RFS) (P < 0.001, HR = 1.570, 95%CI: 1.221-2.018) independent of other prognostic factors. Patients with a low SF were more likely to have both favorable OS and RFS (both P < 0.001), and vice versa. The 1-, 3-, and 5-year OS and RFS rates were 91.4%, 80.1%, 71.7%, and 78.0%, 53.0%, 47.3% in low SF group, and 91.6%, 60.2%, 45.2%, and 61.3%, 36.4%, 29.0% in high SF group, respectively. Conclusions: Preoperative SF was a simple, inexpensive, convenient and reliable prognostic factor that could predict survival outcomes in HCC patients who received radical hepatic resection.