A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection
BackgroundEarly tumor recurrence is one of the most significant poor prognostic factors for patients with HCC after R0 resection. The aim of this study is to identify risk factors of early recurrence, in addition, to develop a nomogram model predicting early recurrence of HCC patients.MethodsA total...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1133807/full |
| _version_ | 1827987807227871232 |
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| author | Huanhuan Wang Runkun Liu Huanye Mo Runtian Li Jie Lian Qingguang Liu Shaoshan Han |
| author_facet | Huanhuan Wang Runkun Liu Huanye Mo Runtian Li Jie Lian Qingguang Liu Shaoshan Han |
| author_sort | Huanhuan Wang |
| collection | DOAJ |
| description | BackgroundEarly tumor recurrence is one of the most significant poor prognostic factors for patients with HCC after R0 resection. The aim of this study is to identify risk factors of early recurrence, in addition, to develop a nomogram model predicting early recurrence of HCC patients.MethodsA total of 481 HCC patients after R0 resection were enrolled and divided into a training cohort (n = 337) and a validation cohort (n = 144). Risk factors for early recurrence were determined based on Cox regression analysis in the training cohort. A nomogram incorporating independent risk predictors was established and validated.ResultsEarly recurrence occurred in 37.8% of the 481 patients who underwent curative liver resection of HCC. AFP ≥ 400 ng/mL (HR: 1.662; P = 0.008), VEGF-A among 127.8 to 240.3 pg/mL (HR: 1.781, P = 0.012), VEGF-A > 240.3 pg/mL (HR: 2.552, P < 0.001), M1 subgroup of MVI (HR: 2.221, P = 0.002), M2 subgroup of MVI (HR: 3.120, P < 0.001), intratumor necrosis (HR: 1.666, P = 0.011), surgical margin among 5.0 to 10.0 mm (HR: 1.601, P = 0.043) and surgical margin < 5.0 mm (HR: 1.790, P = 0.012) were found to be independent risk factors for recurrence-free survival in the training cohort and were used for constructing the nomogram. The nomogram indicated good predictive performance with an AUC of 0.781 (95% CI: 0.729-0.832) and 0.808 (95% CI: 0.731-0.886) in the training and validation cohorts, respectively.ConclusionsElevated serum concentrations of AFP and VEGF-A, microvascular invasion, intratumor necrosis, surgical margin were independent risk factors of early intrahepatic recurrence. A reliable nomogram model which incorporated blood biomarkers and pathological variables was established and validated. The nomogram achieved desirable effectiveness in predicting early recurrence in HCC patients. |
| first_indexed | 2024-04-09T23:52:48Z |
| format | Article |
| id | doaj.art-b6aa7af7a8c04258b8361af30d43c175 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T23:52:48Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-b6aa7af7a8c04258b8361af30d43c1752023-03-17T05:14:56ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.11338071133807A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resectionHuanhuan Wang0Runkun Liu1Huanye Mo2Runtian Li3Jie Lian4Qingguang Liu5Shaoshan Han6Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Pathology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaBackgroundEarly tumor recurrence is one of the most significant poor prognostic factors for patients with HCC after R0 resection. The aim of this study is to identify risk factors of early recurrence, in addition, to develop a nomogram model predicting early recurrence of HCC patients.MethodsA total of 481 HCC patients after R0 resection were enrolled and divided into a training cohort (n = 337) and a validation cohort (n = 144). Risk factors for early recurrence were determined based on Cox regression analysis in the training cohort. A nomogram incorporating independent risk predictors was established and validated.ResultsEarly recurrence occurred in 37.8% of the 481 patients who underwent curative liver resection of HCC. AFP ≥ 400 ng/mL (HR: 1.662; P = 0.008), VEGF-A among 127.8 to 240.3 pg/mL (HR: 1.781, P = 0.012), VEGF-A > 240.3 pg/mL (HR: 2.552, P < 0.001), M1 subgroup of MVI (HR: 2.221, P = 0.002), M2 subgroup of MVI (HR: 3.120, P < 0.001), intratumor necrosis (HR: 1.666, P = 0.011), surgical margin among 5.0 to 10.0 mm (HR: 1.601, P = 0.043) and surgical margin < 5.0 mm (HR: 1.790, P = 0.012) were found to be independent risk factors for recurrence-free survival in the training cohort and were used for constructing the nomogram. The nomogram indicated good predictive performance with an AUC of 0.781 (95% CI: 0.729-0.832) and 0.808 (95% CI: 0.731-0.886) in the training and validation cohorts, respectively.ConclusionsElevated serum concentrations of AFP and VEGF-A, microvascular invasion, intratumor necrosis, surgical margin were independent risk factors of early intrahepatic recurrence. A reliable nomogram model which incorporated blood biomarkers and pathological variables was established and validated. The nomogram achieved desirable effectiveness in predicting early recurrence in HCC patients.https://www.frontiersin.org/articles/10.3389/fonc.2023.1133807/fullhepatocellular carcinomaearly recurrencenomogram modelMVIVEGF-A |
| spellingShingle | Huanhuan Wang Runkun Liu Huanye Mo Runtian Li Jie Lian Qingguang Liu Shaoshan Han A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection Frontiers in Oncology hepatocellular carcinoma early recurrence nomogram model MVI VEGF-A |
| title | A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection |
| title_full | A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection |
| title_fullStr | A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection |
| title_full_unstemmed | A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection |
| title_short | A novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after R0 resection |
| title_sort | novel nomogram predicting the early recurrence of hepatocellular carcinoma patients after r0 resection |
| topic | hepatocellular carcinoma early recurrence nomogram model MVI VEGF-A |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1133807/full |
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