Analysis of risk factors for angiolymphatic invasion and establishment of a predictive nomogram for hepatoblastomas

Ke, Meng; Zhou, Yan; Yang, Changzhen; Li, Long; Diao, Mei

doi:10.1016/j.jpedsurg.2022.02.024

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…In our previous study, we constructed a preoperative model to predict the presence of microvascular invasion in surgical specimens based on PRETEXT stages, age, and macrovascular invasion. The external validation set proved that the model has a good predictive ability 29 . Future methods for noninvasive microvascular invasion detection with higher accuracy are necessary.…”

Section: Discussionmentioning

confidence: 91%

“…The external validation set proved that the model has a good predictive ability. 29 Future methods for noninvasive microvascular invasion detection with higher accuracy are necessary. Ultimately, the status of microvascular invasion may help clinicians determine treatment plans, particularly concerning surgical intervention, and provide more accurate prognostication.…”

Section: Discussionmentioning

confidence: 99%

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A nomogram model to predict prognosis of patients with hepatoblastoma

Zhou

Yang

et al. 2022

Pediatric Blood & Cancer

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Background: Hepatoblastomas (HBs) are malignant liver tumors that most commonly develop in pediatric patients. Microvascular invasion may be a prognosis factor for patients with HBs. This study aimed to construct a model to predict the survival outcome in HBs. Methods:We retrospectively analyzed the clinical data of 311 patients with HBs who underwent surgical resection at our institution between June 2014 and August 2021.First, patients were divided into two groups: those who had pathologic microvascular invasion (n = 146) and those who did not (n = 165). Propensity score-matched (PSM) analysis was carried out between the two groups. The preoperative parameters and overall survival (OS) rate were compared between the two groups. Second, all 311 patients were randomly divided into the training and validation cohort in a ratio of 4:1. A nomogram was created in the training cohort to visualize the prediction of OS.Moreover, the validation cohort was used for validation.Results: Multivariate analysis suggested that age, histology type, microvascular invasion, multifocality, distant metastasis, and macrovascular involvement are independent prognostic factors for HBs. The nomogram showed good predictive ability in the training and validation cohorts with a C-index of 0.878 (95% CI, 0.831-0.925) and 0.847 (95% CI, 0.757-0.937), respectively. The calibration curve indicated good agreement between the prediction and observation for one-, two-, and three-year OS probabilities. Conclusion:By combining preoperative imaging results and other clinical data, we established a nomogram to predict OS probability for patients with HB, which could be a potential tool to guide personalized treatment.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

A nomogram model to predict prognosis of patients with hepatoblastoma

Zhou

Yang

et al. 2022

Pediatric Blood & Cancer

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“…HB exhibits characteristics such as expansile growth within the capsule and the presence of metastatic cancer nests within the chemotherapy regression area that are still contained within the capsule. Furthermore, postoperative chemotherapy may be crucial for eliminating minimal residual tumor tissue and inhibiting occult micrometastases[ 25 - 27 ]. We successfully performed extreme liver resection on HB patients whose major blood vessels were involved, and complete resection was achieved.…”

Section: Discussionmentioning

confidence: 99%

Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

Xiu,

Liu,

Zhang

et al. 2024

World J Gastrointest Surg

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BACKGROUND The management of hepatoblastoma (HB) becomes challenging when the tumor remains in close proximity to the major liver vasculature (PMV) even after a full course of neoadjuvant chemotherapy (NAC). In such cases, extreme liver resection can be considered a potential option. AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC. METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023. We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC. RESULTS Sixty-seven children diagnosed with HB underwent surgical resection. The age at diagnosis was 21.4 ± 18.8 months, and 40 boys and 27 girls were included. Fifty-nine (88.1%) patients had a single tumor, 39 (58.2%) of which was located in the right lobe of the liver. A total of 47 patients (70.1%) had PRE-TEXT III or IV. Thirty-nine patients (58.2%) underwent delayed resection. After a full course of NAC, 16 patients still had close PMV (within 1 cm in two patients, touching in 11 patients, compressing in four patients, and showing tumor thrombus in three patients). There were 6 patients of tumors in the middle lobe of the liver, and four of those patients exhibited liver anatomy variations. These 16 children underwent extreme liver resection after comprehensive preoperative evaluation. Intraoperative procedures were performed according to the preoperative plan, and the operations were successfully performed. Currently, the 3-year event-free survival of 67 children with HB is 88%. Among the 16 children who underwent extreme liver resection, three experienced recurrence, and one died due to multiple metastases. CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible. This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis. Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB, particularly for assessing vascular involvement, remnant liver volume and anatomical variations.

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“…In the past two decades, pediatric liver transplantation has developed rapidly and gradually become the main treatment for multiple hepatic lobe HB. Bene ting from effective adjuvant chemotherapy and strict perioperative management, the 5-year survival rate after HB liver transplantation in children has increased to 60%-80% [24]. At the same time, in order to solve the problem of insu cient number of donors, liver transplantation has been developed from allogeneic liver transplantation to autologous liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of nomogram prognostic model for predicting survival in hepatoblastoma patients: a population-based study

Wang,

Fu,

et al. 2024

Updates Surg

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BackgroundFor patients with hepatoblastoma (HB), current staging system is not accurate in predicting survival outcomes. The aim of this study was to develop two accurate survival prediction models to guide clinical decision making. MethodsA retrospective analysis of 424 HB patients was performed from 2004 to 2015 using the Surveillance, Epidemiology and End Results (SEER) database. Univariate and multivariate Cox regression analysis was used to screen for variables. The identi ed variables were used to build survival prediction model. The performance of the nomogram models was assessed based on the concordance index (C-index), calibration plot, and receiver operating characteristic (ROC) curve. ResultsThe Cox regression analysis identi ed six variables affecting overall survival (OS) in HB patients, including race, tumor size, lymph node involvement, distant metastases, surgery and chemotherapy. And the Cox regression analysis identi ed ve variables including race, lymph node involvement, distant metastases, surgery and chemotherapy that affect cancer-speci c survival (CCS) in HB patients. In the training cohort, the C-index of the nomogram in predicting the OS was 0.791[95% con dence intervals (95% CI): 0.717-0.865], CSS was 0.805(95% CI: 0.728-0.882). In the validation cohort, the C-index of the nomogram in predicting the OS was 0.712 (95% CI: 0.511-0.913), the CSS was 0.751 (95% CI: 0.566-0.936). In the training cohort, the area under the receiver operator characteristics curve (AUC) values of the nomogram in prediction of the 1, 3, and 5-year OS were 0.842 (95% CI: 0.739-0.944), 0.759 (95% CI: 0.670-0.849), and 0.770 (95% CI: 0.686-0.852), respectively. In the validation cohort, the AUC values for prediction of the 1, 3, and 5-year OS were 0.920 (95% CI: 0.806-1.034), 0.863 (95% CI: 0.750-0.976), and 0.844 (95% CI: 0.721-0.967), respectively. ConclusionTwo nomogram models were developed and validated in this study which provided accurate prediction of the OS and CSS in HB patients. The constructed models can be used for predicting survival outcomes and guide treatment for HB patients.

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Analysis of risk factors for angiolymphatic invasion and establishment of a predictive nomogram for hepatoblastomas

Cited by 4 publications

References 31 publications

A nomogram model to predict prognosis of patients with hepatoblastoma

A nomogram model to predict prognosis of patients with hepatoblastoma

Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

Construction and validation of nomogram prognostic model for predicting survival in hepatoblastoma patients: a population-based study

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