Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors
Abstract Background and Aims Extrahepatic recurrence (EHR) is one of the major reasons for the poor prognosis of hepatocellular carcinoma (HCC). The present study aimed to develop and assess the performance of predictive models by using a combination of presurgical circulating tumor cell (CTCs) data...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6178 |
| _version_ | 1797744819833929728 |
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| author | Hao‐Wen Wei Shui‐Ling Qin Jing‐Xuan Xu Yi‐Yue Huang Yuan‐Yuan Chen Liang Ma Lu‐Nan Qi |
| author_facet | Hao‐Wen Wei Shui‐Ling Qin Jing‐Xuan Xu Yi‐Yue Huang Yuan‐Yuan Chen Liang Ma Lu‐Nan Qi |
| author_sort | Hao‐Wen Wei |
| collection | DOAJ |
| description | Abstract Background and Aims Extrahepatic recurrence (EHR) is one of the major reasons for the poor prognosis of hepatocellular carcinoma (HCC). The present study aimed to develop and assess the performance of predictive models by using a combination of presurgical circulating tumor cell (CTCs) data and clinicopathological features to screen patients at high risk of EHR to achieve precise decision‐making. Patients and Methods A total of 227 patients with recurrent HCC and preoperative CTC data from January 2014 to August 2019 were enrolled. All patients were randomly assigned to one of two cohorts: development or validation. Two preoperative and postoperative nomogram models for EHR prediction were developed and multi‐dimensionally validated. Results Patients with EHR had generally lower recurrence‐free survival (p < 0.001), and overall survival (p < 0.001), and significantly higher CTC counts (epithelial CTCs, epithelial/mesenchymal hybrid CTCs, and mesenchymal CTCs count, all p < 0.05) than those without EHR. Univariate and multivariate analyses revealed that EHR was associated with four risk factors in the development cohort: total CTC count (p = 0.014), tumor size (p = 0.028), node number (p = 0.045), and microvascular invasion (p = 0.035). These factors were incorporated into two nomogram models (preoperative and postoperative), which reliably predicted EHR through multidimensional verification (e.g., calibration plot, receiver operating characteristic analysis, decision curve analysis, and clinical impact curve analysis) in the development and validation cohorts, respectively. With threshold of scores of 100.3 and 176.8 before and after surgery respectively, both nomograms were able to stratify patients into two distinct prognostic subgroups (all p < 0.05). Conclusion The present study proposed two nomogram models integrating presurgical CTC counts and clinicopathological risks and showed relatively good predictive performance of EHR, which may be beneficial to the clinical practice of HCC recurrence. Further multicenter studies are needed to assess its general applicability. |
| first_indexed | 2024-03-12T15:14:44Z |
| format | Article |
| id | doaj.art-2073caa4bc724cc89f4404e731ae9b77 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-12T15:14:44Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-2073caa4bc724cc89f4404e731ae9b772023-08-11T14:51:17ZengWileyCancer Medicine2045-76342023-07-011214150651507810.1002/cam4.6178Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factorsHao‐Wen Wei0Shui‐Ling Qin1Jing‐Xuan Xu2Yi‐Yue Huang3Yuan‐Yuan Chen4Liang Ma5Lu‐Nan Qi6Department of Hepatobiliary Surgery Guangxi Medical University Cancer Hospital Nanning ChinaDepartment of Hepatobiliary Surgery Guangxi Medical University Cancer Hospital Nanning ChinaDepartment of Hepatobiliary Surgery Guangxi Medical University Cancer Hospital Nanning ChinaDepartment of Hepatobiliary Surgery Guangxi Medical University Cancer Hospital Nanning ChinaDepartment of Ultrasound First Affiliated Hospital of Guangxi Medical University Nanning ChinaDepartment of Hepatobiliary Surgery Guangxi Medical University Cancer Hospital Nanning ChinaDepartment of Hepatobiliary Surgery Guangxi Medical University Cancer Hospital Nanning ChinaAbstract Background and Aims Extrahepatic recurrence (EHR) is one of the major reasons for the poor prognosis of hepatocellular carcinoma (HCC). The present study aimed to develop and assess the performance of predictive models by using a combination of presurgical circulating tumor cell (CTCs) data and clinicopathological features to screen patients at high risk of EHR to achieve precise decision‐making. Patients and Methods A total of 227 patients with recurrent HCC and preoperative CTC data from January 2014 to August 2019 were enrolled. All patients were randomly assigned to one of two cohorts: development or validation. Two preoperative and postoperative nomogram models for EHR prediction were developed and multi‐dimensionally validated. Results Patients with EHR had generally lower recurrence‐free survival (p < 0.001), and overall survival (p < 0.001), and significantly higher CTC counts (epithelial CTCs, epithelial/mesenchymal hybrid CTCs, and mesenchymal CTCs count, all p < 0.05) than those without EHR. Univariate and multivariate analyses revealed that EHR was associated with four risk factors in the development cohort: total CTC count (p = 0.014), tumor size (p = 0.028), node number (p = 0.045), and microvascular invasion (p = 0.035). These factors were incorporated into two nomogram models (preoperative and postoperative), which reliably predicted EHR through multidimensional verification (e.g., calibration plot, receiver operating characteristic analysis, decision curve analysis, and clinical impact curve analysis) in the development and validation cohorts, respectively. With threshold of scores of 100.3 and 176.8 before and after surgery respectively, both nomograms were able to stratify patients into two distinct prognostic subgroups (all p < 0.05). Conclusion The present study proposed two nomogram models integrating presurgical CTC counts and clinicopathological risks and showed relatively good predictive performance of EHR, which may be beneficial to the clinical practice of HCC recurrence. Further multicenter studies are needed to assess its general applicability.https://doi.org/10.1002/cam4.6178circulating tumor cells (CTC)extrahepatic recurrence (EHR)hepatic resectionhepatocellular carcinoma (HCC)prediction model |
| spellingShingle | Hao‐Wen Wei Shui‐Ling Qin Jing‐Xuan Xu Yi‐Yue Huang Yuan‐Yuan Chen Liang Ma Lu‐Nan Qi Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors Cancer Medicine circulating tumor cells (CTC) extrahepatic recurrence (EHR) hepatic resection hepatocellular carcinoma (HCC) prediction model |
| title | Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors |
| title_full | Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors |
| title_fullStr | Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors |
| title_full_unstemmed | Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors |
| title_short | Nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors |
| title_sort | nomograms for postsurgical extrahepatic recurrence prediction of hepatocellular carcinoma based on presurgical circulating tumor cell status and clinicopathological factors |
| topic | circulating tumor cells (CTC) extrahepatic recurrence (EHR) hepatic resection hepatocellular carcinoma (HCC) prediction model |
| url | https://doi.org/10.1002/cam4.6178 |
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