Background and Aims: Early postoperative recurrence is the main factor affecting the prognosis of hepatocellular carcinoma (HCC) patients. This study was conducted to investigate the risk factors for early recurrence in HCC patients after hepatectomy and establish an evaluation model, so as to provide basis for predicting recurrence risk and improving prognosis. 
Methods: The clinical data of 225 patients with HCC treated in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between 2011 and 2016 were retrospectively analyzed. The occurrence of early postoperative recurrence (recurrence with 2 years after hepatectomy) among the patients were analyzed. The independent risk factors for early recurrence were determined by Logistic regression model, the efficiencies of the variables in predicting the early recurrence were evaluated by receiver operating characteristic curve (ROC) and area under curve (AUC), and the risk scoring model for early recurrence was established by Cox regression equation.
Results: Among the 225 patients, early postoperative recurrence occurred in 130 cases (57.8%). Tumor number, γ-glutamyl transpeptidase (γ-GT), and neutrophil-lymphocyte ratio (NLR) were independent risk factors for early postoperative recurrence in HCC patients (all P<0.05). The AUC of serum γ-GT, NLR and the combination of γ-GT and NLR for prediction early postoperative recurrence were 67.6%, 59.1% and 70.4%, respectively. After risk scoring model was created by incorporating tumor number, γ-GT and NLR into the regression equation, a code of 1 was assigned to γ-GT >108 U/L, 2 was assigned to NLR>2.11, and 3 was assigned to tumor number >1, otherwise 0 was assigned, according to the HR values. The possible score given bythe risk scoring model ranged from 0 to 6. According to this model, the 1-, 3- and 5-year disease-free survival rates were 76.9%, 44.5% and 32.8% in patients in low risk group (score <3), and were 33.4%, 20.1%, and 6.69% in patients in high risk group (score ≥3), and the difference had statistical significance (P<0.001).
Conclusion: Tumor number, γ-GT and NLR are independent risk factors for early postoperative recurrence in HCC patients. The established prediction model can be used for stratifying the risk of early recurrence in HCC patients, and thereby may help choose an appropriate treatment plan to improve the prognosis of the patients.