A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy

Pan, Yangxun; Chen, Jian Cong; Fang, A.; Wang, Xiao Hui; Chen, Jin Bin; Wang, Jun Cheng; He, Wei; Fu, Yi; Xu, Li; Chen, Min Shan; Zhang, Yaojun; Li, Qi Jiong; Zhou, Zhifen

doi:10.1186/s40880-019-0404-6

Cited by 42 publications

(23 citation statements)

References 44 publications

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“…Due to the high cumulative 5-year recurrence rate of intrahepatic recurrent HCC after initial ablation, optimal treatment strategy for those patients is urgently warranted. However, because of limited data available regarding the optimal therapeutic strategy for recurrent HCC receiving local ablation as initial treatment, the selection between providing re-ablation or resection as salvage therapy for recurrent HCC still remains highly debatable [13, 20-25]. Prospective randomized trials could provide reliable evidence; however, these are difficult to perform because treatment courses are determined considering various clinical factors, such as tumor size and location.…”

Section: Discussionmentioning

confidence: 99%

Surgical Resection versus Re-Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma after Initial Ablation Therapy

et al. 2020

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Background and Aims: Whether surgical resection or repeated ablation should be recommended for intrahepatic recurrent hepatocellular carcinoma (HCC) conforming to the Milan criteria after initial ablation remains unclear. In this study, we compared the outcomes of patients who underwent surgical resection with those who underwent re-ablation for recurrent HCC after initial curative-intent ablation. Methods: The data of 28 and 98 patients who underwent surgical resection and re-ablation, respectively, for recurrent HCC after initial ablation between January 2003 and 2017 were analyzed using propensity score matching. Results: Before matching, the 1-, 3-, and 5-year overall survival (OS) rates were 95.7, 83.0, and 74.4% for the ablation group, compared to 92.9, 89.1, and 70.9% for the resection group (p = 0.490). The corresponding disease-free survival (DFS) rates were 67.5, 40.1, and 25.6% for the ablation group and were 85.4, 59.9, and 53.3% for the resection group (p = 0.018). After matching, the 1-, 3-, and 5-year OS rates for the ablation and resection group were 95.2, 85.5 and 81.8% versus 96.0, 96.0, and 76.4%, respectively (p = 0.550). The 1-, 3-, and 5-year DFS rates were 58.0, 39.5, and 29.9% for the ablation group and were 95.8, 67.2, and 59.8% for the resection group (p = 0.004). Cox proportional hazards model identified surgical resection as the only significant prognostic factor for DFS but not for OS. Conclusion: For intrahepatic recurrent HCC patients after initial ablation, surgical resection could provide better DFS than re-ablation, while no difference in OS was observed between the 2 treatment groups.

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Section: Discussionmentioning

confidence: 99%

Surgical Resection versus Re-Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma after Initial Ablation Therapy

et al. 2020

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“…Early prediction of MVI in hepatocellular carcinoma remains elusive. Studies have shown that microvascular violation of state can be reflected by specific clinical hematological indicators, such as desgamma-carboxyprothrombin (PIVKA-II), alpha-fetoprotein (AFP), and peripheral neutrophil to lymphocyte ratio (NLR) (7,8); also, it can be predicted by tumor size, multiple tumor nodules, tumor rough edges, incomplete capsule, and nuclear magnetic resonance arterial peritumoral enhancement imaging characteristics and changes in peritumoral hepatobiliary specific density of microvessels (9)(10)(11)(12). Currently, Radiomics is the most popular method for microvascular invasion assessment and prediction (13).…”

Section: Importance Of Microvascular Invasion Risk and Tumor Size On mentioning

confidence: 99%

Importance of Microvascular Invasion Risk and Tumor Size on Recurrence and Survival of Hepatocellular Carcinoma After Anatomical Resection and Non-anatomical Resection

Zeng

et al. 2021

Front. Oncol.

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Purpose: To establish a valid prediction model to prognose the occurrence of microvascular invasion (MVI), and to compare the efficacy of anatomic resection (AR) or non-anatomic resection (NAR) for hepatocellular carcinoma (HCC).Methods: Two hundred twenty-eight patients with HCC who underwent surgical treatment were enrolled. Their hematological indicators, MRI imaging features, and outcome data were acquired.Result: In the multivariable analysis, alpha-fetoprotein >15 ng/mL, neutrophil to lymphocyte ratio >3.8, corona enhancement, and peritumoral hypointensity on hepatobiliary phase were associated with MVI. According on these factors, the AUROC of the predictive model in the primary and validation cohorts was 0.884 (95% CI: 0.829, 0.938) and 0.899 (95% CI: 0.821, 0.967), respectively. Patients with high risk of MVI or those with low risk of MVI but tumor size >5 cm in the AR group were associated with a lower rate of recurrence and death than patients in the NAR group; however, when patients are in the state of low-risk MVI with tumor size >5 cm, there is no difference in the rate of recurrence and death between AR and NAR.Conclusion: Our predictive model for HCC with MVI is convenient and accurate. Patients with high-risk of MVI or low-risk of MVI but tumor size >5 cm executing AR is of great necessity.

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“…Moreover, the number of studies revealed the association between different clinicopathological factors like AFP level, tumor size, HBsAg and vascular invasion, etc. with the tumor recurrence in HCC; thus, these were also established as prognostic indicators for prediction of HCC recurrence [13,16,[20][21][22][23]. However, the molecular and genetic aspect of tumor recurrence remains invincible from them.…”

Section: Introductionmentioning

confidence: 99%

Integrative multi-omics approach for stratification of tumor recurrence risk groups of Hepatocellular Carcinoma patients

Kaur

Lathwal

Raghava

2021

Preprint

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Postoperative tumor recurrence is one of the major concerns associated with the poor prognosis of HCC patients. There is yet to elucidate a standard surveillance system for HCC recurrence risk owing to complexity of this malignancy. Generation of multi-omics data from patients facilitate the identification of robust signatures for various diseases. Thus, the current study is an attempt to develop the prognostic models employing multi-omics data to significantly (p-value <0.05) stratify the recurrence high-risk (median Recurrence Free Survival time (RFS) =<12 months) and low-risk groups (median RFS >12 months). First, we identified key 90RNA, 50miRNA and 50 methylation features and developed prognostic models; attained reasonable performance (C-Index >0.70, HR >2.5), on training and validation datasets. Subsequently, we developed a prognostic (PI) model by integrating the four multi-omics features (SUZ12, hsa-mir-3936, cg18465072, and cg22852503), that are biologically inter-linked with each other. This model achieved reasonable performance on training and validation dataset, i.e. C-Index 0.72, HR of 2.37 (1.61 - 3.50), p-value of 6.72E-06, Brier score 0.19 on training dataset, and C-Index 0.72 (95% CI: 0.63 - 0.80), HR of 2.37 (95% CI: 1.61 - 3.50), p-value of 0.015, Brier score 0.19 on validation dataset. Eventually, Drugbank data was investigated to elucidate therapeutic potential of these signatures. We have identified nine potential drugs against three genes (CA9, IL1A, KCNJ15) that are positively correlated with the tumor recurrence. We anticipate these results from our study will help researchers and clinicians to improve the HCC recurrence surveillance, eventually outcome of patients.

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A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy

Cited by 42 publications

References 44 publications

Surgical Resection versus Re-Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma after Initial Ablation Therapy

Surgical Resection versus Re-Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma after Initial Ablation Therapy

Importance of Microvascular Invasion Risk and Tumor Size on Recurrence and Survival of Hepatocellular Carcinoma After Anatomical Resection and Non-anatomical Resection

Integrative multi-omics approach for stratification of tumor recurrence risk groups of Hepatocellular Carcinoma patients

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