An Eastern Hepatobiliary Surgery Hospital Microvascular Invasion Scoring System in Predicting Prognosis of Patients with Hepatocellular Carcinoma and Microvascular Invasion After R0 Liver Resection: A Large-Scale, Multicenter Study

Zhang, Xiuping; Wang, Kang; Wei, Xiao‐Hong; Li, Le‐Qun; Sun, Hui‐Chuan; Wen, Tianfu; Chai, Zong‐Tao; Chen, Zhenhua; Shi, Jie; Guo, Wei-Xing; Xie, Dong; Wang, Cong; Wu, Mengchao; Lau, Wan Yee; Cheng, Shuqun

doi:10.1634/theoncologist.2018-0868

Cited by 58 publications

(41 citation statements)

References 41 publications

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“…Scholars have not yet come to a consensus regarding the prognostic factors of cHCC-CCA. Although previous studies have confirmed that microvascular invasion (MVI) is a prognostic factor for tumor recurrence and is associated with poor survival outcomes in HCC [11][12][13][14] and ICC [15,16], the relationship between prognosis and the presence of MVI in cHCC-CCA patients has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?

Wang

et al. 2020

Eur Radiol

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Objectives To explore which preoperative clinical data and conventional MRI findings may indicate microvascular invasion (MVI) of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and have clinical significance. Methods The study enrolled 113 patients with histopathologically confirmed cHCC-CCA (MVI-positive group [n = 56], MVI-negative group [n = 57]). Two radiologists retrospectively assessed the preoperative MRI features (qualitative analysis of morphology and dynamic enhancement features), and each lesion was assigned according to the LI-RADS. Preoperative clinical data were also evaluated. Logistic regression analyses were used to assess the relative value of these parameters as potential predictors of MVI. Recurrence-free survival (RFS) rates after hepatectomy in the two groups were estimated using Kaplan–Meier survival curves and compared using the log-rank test. Results The majority of cHCC-CCAs were categorized as LR-M. On multivariate analysis, a higher serum AFP level (OR, 0.523; 95% CI, 0.282–0.971; p = 0.040), intratumoral fat deposition (OR, 14.368; 95% CI, 2.749–75.098; p = 0.002), and irregular arterial peritumoral enhancement (OR, 0.322; 95% CI, 0.164–0.631; p = 0.001) were independent variables associated with the MVI of cHCC-CCA. After hepatectomy, patients with MVI of cHCC-CCA showed earlier recurrence than those without MVI (hazard ratio [HR], 0.402; 95% CI, 0.189–0.854, p = 0.013). Conclusion A higher serum AFP level and irregular arterial peritumoral enhancement are potential predictive biomarkers for the MVI of cHCC-CCA, while intratumoral fat detected on MRI suggests a low risk of MVI. Furthermore, cHCC-CCAs with MVI may have worse surgical outcomes with regard to early recurrence than those without MVI. Key Points • Higher serum levels of AFP combined with irregular arterial peritumoral enhancement are independent risk factors for the MVI of cHCC-CCA, while fat deposition might be a protective factor. • cHCC-CCA with MVI may have a higher risk of early recurrence after surgery. • Most cHCC-CCAs were categorized as LR-M in this study, and no significant difference was found in MVI based on LI-RADS category.

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Section: Introductionmentioning

confidence: 99%

Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?

Wang

et al. 2020

Eur Radiol

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“…Unfortunately, about half of the HCC patients suffer from postoperative recurrence in a few years, resulting in surgical failure and poor prognosis (3). Microvascular invasion (MVI) is a histopathologic evidence of local aggression and is considered as a strong predictor of postoperative recurrence in HCC (3)(4)(5)(6). Based on the above research evidences, the 2017 Guidelines for Diagnosis and Treatment of Liver Cancer in China have required the HCC pathological diagnosis to supply the description of MVI status based on pathological examination and necessary immunohistochemical staining (7).…”

Section: Introductionmentioning

confidence: 99%

Preoperative Prediction Power of Imaging Methods for Microvascular Invasion in Hepatocellular Carcinoma: A Systemic Review and Meta-Analysis

et al. 2020

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Background: To compare the predictive power between radiomics and non-radiomics (conventional imaging and functional imaging methods) for preoperative evaluation of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Methods: Comprehensive publications were screened in PubMed, Embase, and Cochrane Library. Studies focusing on the discrimination values of imaging methods, including radiomics and non-radiomics methods, for MVI evaluation were included in our meta-analysis. Results: Thirty-three imaging studies with 5,462 cases, focusing on preoperative evaluation of MVI status in HCC, were included. The sensitivity and specificity of MVI prediction in HCC were 0.78 [95% confidence interval (CI): 0.75-0.80; I 2 = 70.7%] and 0.78 (95% CI: 0.76-0.81; I 2 = 0.0%) for radiomics, respectively, and were 0.73 (95% CI: 0.71-0.75; I 2 = 83.7%) and 0.82 (95% CI: 0.80-0.83; I 2 = 86.5%) for non-radiomics, respectively. The areas under the receiver operation curves for radiomics and non-radiomics to predict MVI status in HCC were 0.8550 and 0.8601, respectively, showing no significant difference. Conclusion: The imaging method is feasible to predict the MVI state of HCC. Radiomics method based on medical image data is a promising application in clinical practice and can provide quantifiable image features. With the help of these features, highly consistent prediction performance will be achieved in anticipation.

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“…For large HCC, tumor burden could have a more signi cant function in determining the OS compared to the liver function. Microvascular invasion (MVI) is a critical risk factor for HCC prognosis [33][34][35]. Previous studies demonstrated that the incidence of MVI increased with tumor size [36].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of the ALBI grade among patients with single hepatocellular carcinoma without macrovascular invasion

Chen

Zhang

Wang

et al. 2020

Preprint

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Background: Although evidence for the application of albumin–bilirubin (ALBI) grading system to assess liver function in hepatocellular carcinoma (HCC) is available, less is known whether it can be applied to determine the prognosis of single HCC with different tumor sizes. This study aimed to address this gap.Methods: Here, we enrolled patients who underwent hepatectomy due to single HCC from the year 2010 to 2014. Analyses were performed to test the potential of ALBI grading system to monitor the long-term survival of single HCC subjects with varying tumor sizes.Results: Overall, 265 participants were recruited. The overall survival (OS) among patients whose tumors were ≤ 7 cm was remarkably higher compared to those whose tumors were > 7 cm. The Cox proportional hazards regression model identified the tumor differentiation grade, ALBI grade, and maximum tumor size as key determinants of the OS. The ALBI grade could stratify the patients who had a single tumor ≤ 7 cm into two distinct groups with different prognoses. The OS between ALBI grades 1 and 2 was comparable for patients who had a single tumor > 7 cm.Conclusions: We show that ALBI grading system can predict disease outcomes of single HCC patients with tumor size ≤ 7 cm. However, the ALBI grade may not predict capability the prognosis of patients with single tumor > 7 cm.

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An Eastern Hepatobiliary Surgery Hospital Microvascular Invasion Scoring System in Predicting Prognosis of Patients with Hepatocellular Carcinoma and Microvascular Invasion After R0 Liver Resection: A Large-Scale, Multicenter Study

Cited by 58 publications

References 41 publications

Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?

Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?

Preoperative Prediction Power of Imaging Methods for Microvascular Invasion in Hepatocellular Carcinoma: A Systemic Review and Meta-Analysis

Prognostic value of the ALBI grade among patients with single hepatocellular carcinoma without macrovascular invasion

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