Previous studies have reported low serum creatine kinase (s‑CK) levels as a poor prognostic factor in various cancers. However, there have been no reports on its significance in hepatocellular carcinoma. The present study aimed to evaluate the association of the preoperative s‑CK levels with clinicopathologic features and their prognostic impact on survival in patients with hepatocellular carcinoma. This retrospective study included 163 patients with hepatocellular carcinoma (127 male and 36 female patients; median age, 69 years) who underwent radical liver resection between January 2004 and December 2021. A cutoff preoperative s‑CK level of 91 U/l determined by receiver operating characteristic curve analysis was used to evaluate the significance of s‑CK in predicting overall and recurrence‑free survival. In addition, the prognostic impact of s‑CK was evaluated using univariate and multivariate analysis. s‑CK level was not associated with clinicopathologic factors. Overall survival and recurrence‑free survival of the low s‑CK group were significantly worse compared with the high s‑CK group (P=0.043 and P=0.029, respectively). By multivariate analysis, low s‑CK was an independent risk factor for poor overall survival and recurrence‑free survival (P=0.019 and P=0.014, respectively). This trend was the same for male patients, but no significant difference was observed for female patients. Low preoperative s‑CK level might be a poor prognostic biomarker in patients with hepatocellular carcinoma.

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