Hong Wei1, Hanyu Jiang1, Yun Qin1, Yuanan Wu2, Jeong Min Lee3, Fang Yuan1, Tianying Zheng1, Ting Duan1, Zhen Zhang1, Yali Qu1, Jie Chen1, Yuntian Chen1, Zheng Ye1, Shan Yao1, Lin Zhang1, Ting Yang1, Bin Song4,5. 1. Department of Radiology, West China Hospital, Sichuan University, No. 37, GUOXUE Alley, Chengdu, 610041, Sichuan, China. 2. Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China. 3. Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea. 4. Department of Radiology, West China Hospital, Sichuan University, No. 37, GUOXUE Alley, Chengdu, 610041, Sichuan, China. songlab_radiology@163.com. 5. Department of Radiology, Sanya People's Hospital, Sanya, Hainan, China. songlab_radiology@163.com.
Abstract
OBJECTIVES: To establish a risk score integrating preoperative gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) and clinical parameters to predict recurrence after hepatectomy for patients with hepatocellular carcinoma (HCC) and to compare its performance with that of a postoperative score and four clinical staging systems. METHODS: Consecutive patients with surgically confirmed HCC who underwent preoperative EOB-MRI between July 2015 and November 2020 were retrospectively included. Two recurrence risk scores, one incorporating only preoperative variables and the other incorporating all preoperative and postoperative variables, were constructed via Cox regression models. RESULTS: A total of 214 patients (derivation set, n = 150; test set, n = 64) were included. Six preoperative variables, namely tumor number, infiltrative appearance, corona enhancement, alpha-fetoprotein (AFP) level, aspartate aminotransferase (AST) level, and sex, were independently associated with recurrence. After adding postoperative features, microvascular invasion and tumor differentiation were additional significant variables in lieu of corona enhancement and AFP level. Using the above variables, the preoperative score achieved a C-index of 0.741 on the test set, which was comparable with that of the postoperative score (0.729; p = 0.235). The preoperative score yielded a larger time-dependent area under the receiver operating characteristic curve at 1 year (0.844) than three existing systems (0.734-0.742; p < 0.05 for all). Furthermore, the preoperative score stratified patients into two prognostically distinct risk strata with low and high risks of recurrence (p < 0.001). CONCLUSION: The preoperative score integrating EOB-MRI features, AFP and AST levels, and sex improves recurrence risk estimation in HCC. KEY POINTS: • The preoperative risk score incorporating three EOB-MRI findings, AFP and AST levels, and sex achieved comparable performance with that of the postoperative score for predicting recurrence after hepatectomy in patients with HCC. • Two risk strata with low and high risks of recurrence were obtained based on the preoperative score. • The preoperative score may help tailor pretreatment decision-making and facilitate candidate selection for adjuvant clinical trials.
OBJECTIVES: To establish a risk score integrating preoperative gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) and clinical parameters to predict recurrence after hepatectomy for patients with hepatocellular carcinoma (HCC) and to compare its performance with that of a postoperative score and four clinical staging systems. METHODS: Consecutive patients with surgically confirmed HCC who underwent preoperative EOB-MRI between July 2015 and November 2020 were retrospectively included. Two recurrence risk scores, one incorporating only preoperative variables and the other incorporating all preoperative and postoperative variables, were constructed via Cox regression models. RESULTS: A total of 214 patients (derivation set, n = 150; test set, n = 64) were included. Six preoperative variables, namely tumor number, infiltrative appearance, corona enhancement, alpha-fetoprotein (AFP) level, aspartate aminotransferase (AST) level, and sex, were independently associated with recurrence. After adding postoperative features, microvascular invasion and tumor differentiation were additional significant variables in lieu of corona enhancement and AFP level. Using the above variables, the preoperative score achieved a C-index of 0.741 on the test set, which was comparable with that of the postoperative score (0.729; p = 0.235). The preoperative score yielded a larger time-dependent area under the receiver operating characteristic curve at 1 year (0.844) than three existing systems (0.734-0.742; p < 0.05 for all). Furthermore, the preoperative score stratified patients into two prognostically distinct risk strata with low and high risks of recurrence (p < 0.001). CONCLUSION: The preoperative score integrating EOB-MRI features, AFP and AST levels, and sex improves recurrence risk estimation in HCC. KEY POINTS: • The preoperative risk score incorporating three EOB-MRI findings, AFP and AST levels, and sex achieved comparable performance with that of the postoperative score for predicting recurrence after hepatectomy in patients with HCC. • Two risk strata with low and high risks of recurrence were obtained based on the preoperative score. • The preoperative score may help tailor pretreatment decision-making and facilitate candidate selection for adjuvant clinical trials.
Authors: Jorge A Marrero; Laura M Kulik; Claude B Sirlin; Andrew X Zhu; Richard S Finn; Michael M Abecassis; Lewis R Roberts; Julie K Heimbach Journal: Hepatology Date: 2018-08 Impact factor: 17.425
Authors: Thomas Yau; Vikki Y F Tang; Tzy-Jyun Yao; Sheung-Tat Fan; Chung-Mau Lo; Ronnie T P Poon Journal: Gastroenterology Date: 2014-02-25 Impact factor: 22.682
Authors: L-T Chen; E Martinelli; A-L Cheng; G Pentheroudakis; S Qin; G S Bhattacharyya; M Ikeda; H-Y Lim; G F Ho; S P Choo; Z Ren; H Malhotra; M Ueno; B-Y Ryoo; T C Kiang; D Tai; A Vogel; A Cervantes; S-N Lu; C-J Yen; Y-H Huang; S-C Chen; C Hsu; Y-C Shen; J Tabernero; Y Yen; C-H Hsu; T Yoshino; J-Y Douillard Journal: Ann Oncol Date: 2019-12-20 Impact factor: 32.976
Authors: Myung Han Hyun; Young-Sun Lee; Ji Hoon Kim; Chan Uk Lee; Young Kul Jung; Yeon Seok Seo; Hyung Joon Yim; Jong Eun Yeon; Kwan Soo Byun Journal: Hepatology Date: 2018-05-21 Impact factor: 17.425
Authors: Shimul A Shah; Sean P Cleary; Alice C Wei; Ilun Yang; Bryce R Taylor; Alan W Hemming; Bernard Langer; David R Grant; Paul D Greig; Steven Gallinger Journal: Surgery Date: 2006-11-01 Impact factor: 3.982