A nomogram to predict early postoperative recurrence of hepatocellular carcinoma with portal vein tumour thrombus after R0 liver resection: A large-scale,multicenter study |
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| Affiliation: | 1. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University Shanghai, China;2. The No.313 Hospital of PLA, Huludao, Liaoning, China;3. Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China;4. Department of Hepatobiliary Oncology of Sun Yat-sen University Cancer Center, Guangzhou, China;5. Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China;6. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China;1. Institut Bergonié and Université de Bordeaux, Bordeaux, France;2. Leiden University Medical Center, Leiden, the Netherlands;3. European Society of Surgical Oncology Clinical Research Committee, Brussels, Belgium;4. Ghent University Hospital, Ghent, Belgium;5. University of Siena, Siena, Italy;6. Medical University of Gdansk, Gdańsk, Poland;7. Department of Head and Neck Cancer Surgery, Breast Unit, Medical University of Lodz, Cancer Center, Lodz, Poland;8. Royal Marsden NHS Foundation Trust, London, UK;9. Fondazione Policlinico Universitario A. Gemelli, Rome, Italy;10. Aintree University Hospital, Liverpool, UK;11. Clinica Universidad de Navarra, Madrid, Spain;12. Medical School, University of Sheffield, Sheffield and Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK;13. Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland;14. Centre Léon Bérard and Université de Lyon, Lyon, France;15. Medical School, University of Crete, Heraklion, Greece;p. Medical University of Lublin, Poland;q. University of Liverpool, Liverpool, UK;r. Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden;s. Guy''s Hospital, London, UK;t. MD Anderson Cancer Center, Madrid, Spain;1. Department of Radiology and Nuclear Medecine, Institut Curie, PSL Research University, 26 rue d’Ulm, 75248, Paris Cedex 05, France;2. Department of Surgical Oncology, Institut Curie, PSL Research University, 26 rue d’Ulm, 75248, Paris Cedex 05, France;3. Department of Biostatistics, Institut Curie, PSL Research University, 26 rue d’Ulm, 75248, Paris Cedex 05, France;4. Department of Biopathology, Institut Curie, PSL Research University, 26 rue d’Ulm, 75248, Paris Cedex 05, France;1. Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA;2. Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA;3. Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, MD, 20742, USA;4. Department of Surgical Oncology, Mercy Medical Center, Baltimore, MD, 21202, USA;5. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA;6. Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, USA;7. Department of Animal Sciences, Colorado State University, Fort Collins, CO, USA;8. University of South Carolina School of Medicine, Columbia, SC, USA;1. Department of Medicine, University of South Carolina School of Medicine, Columbia, SC, USA;2. Department of Oncology, Mayo Clinic, Rochester, MN, USA;3. Section of Hepatobiliary and Pancreatic Surgery, Division of Subspecialty General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA |
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| Abstract: | BackgroundPortal vein tumour thrombus (PVTT) is a significant poor prognostic factor for hepatocellular carcinoma (HCC). Patients with PVTT limited to a first-order branch or above of the main portal vein (MPV) could benefit from R0 liver resection (LR). A nomogram is needed to predict early postoperative recurrence (ER) in HCC patients with PVTT and to guide selection of these patients for adjuvant therapy to reduce postoperative recurrence risks.MethodsHCC patients with PVTT limited to a first-order branch or above of the MPV after R0 LR as an initial therapy were included. A nomogram using data from a retrospective training cohort was developed with the Cox regression model. The model was tested in a prospective internal validation cohort and three external validation cohorts.ResultsOf 979 patients, 657 developed postoperative ER (67.1%). ER occurred in 165 of 264 patients (62.5%) in the training cohort, 146 of 218 patients (70.0%) in the internal validation cohort, and 204 of 284 patients (71.8%), 77 of 113 patients (68.1%), and 65 of 100 patients (65%) in the three external validation cohorts, respectively. The nomogram included the following variables: hepatitis B surface antigen (HBsAg), PVTT, HBV DNA, satellite nodules, α-fetoprotein, and tumour diameter. The ROC were 0.836, 0.763, 0.802, 0.837, and 0.846 in predicting ER in the five respective cohorts.ConclusionA nomogram was developed and validated to predict postoperative ER in patients with HCC with PVTT after R0 LR. This nomogram could select appropriate patients with high ER risks for postoperative adjuvant therapy. |
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| Keywords: | Hepatocellular carcinoma Portal vein tumour thrombus R0 liver resection Nomogram Early recurrence HCC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" hepatocellular carcinoma PVTT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" portal vein tumour thrombus LR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" liver resection ER" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" early recurrence. |
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