Introduction : Despite a low risk of liver failure and preserved liver function, non-cirrhotic HCC has poor prognosis. To improve clinical outcomes of the curative-intent treatment in non-cirrhotic HCC, identification of prognostic factors accompanied by new treatment strategies are needed. In the current study, we evaluated AROS as a prognostic biomarker in non-cirrhotic HCC.

Methods : mRNA levels of AROS was measured in tumor and non-tumor tissues derived from 283 non-cirrhotic HCC patients. Relationships between clinical characteristics and AROS expression were analyzed using Chi square and Fisher’s exact test. The prognostic significance of AROS expression was analyzed using Kaplan–Meier curves and Cox regression models.

Results : AROS was significantly up-regulated in tumors irrespective of tumor stage and BCLC stage. Additionally, recurrent tissues revealed higher average levels of AROS than non-recurrent tissues for follow-up times of 2 years and 5 years and the differences were statistically significant. High mRNA levels of AROS were associated with tumor stage, BCLC stage, AFP level, vascular invasion, tumor size, and portal vein invasion. HCC patients with higher AROS levels showed higher recurrence and shorter DFS for both short-term and long-term compared to those with AROS-low group. Cox regression analysis demonstrated that AROS is a significant predictor for recurrence and DFS along with large tumor size, tumor multiplicity, vascular invasion, and poor tumor differentiation which are the known prognostic factors.

Conclusions : Our findings on AROS as a prognostic biomarker could be helpful for designing a strategy for the effective treatment and management of non-cirrhotic HCC.