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Computed tomography-based radiomics to predict early recurrence of hepatocellular carcinoma post-hepatectomy in patients background on cirrhosis

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World Journal of Gastroenterology 2024年第15期30卷 2128-2142页

作者： Gui-Xiang Qian Zi-Ling Xu Yong-Hai Li Jian-Lin Lu Xiang-Yi Bu Ming-Tong Wei Wei-Dong Jia Department of Hepatic Surgery Anhui Provincial HospitalThe First Affiliated Hospital of USTCDivision of Life Science and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Hepatic Surgery Anhui Provincial Hospital Affiliated to Anhui Medical UniversityAnhui Medical UniversityHefei 230001Anhui ProvinceChina Department of Anorectal Surgery the First People’s Hospital of HefeiHefei 230001Anhui ProvinceChina

BACKGROUND The prognosis for hepatocellular carcinoma(HCC)in the presence of cirrhosis is unfavourable,primarily attributable to the high incidence of *** To develop a machine learning model for predicting early recurrence(ER)of posthepatectomy HCC in patients with cirrhosis and to stratify patients’overall survival(OS)based on the predicted risk of *** In this retrospective study,214 HCC patients with cirrhosis who underwent curative hepatectomy were *** feature selection was conducted using the least absolute shrinkage and selection operator and recursive feature elimination ***-radiologic features were selected through univariate and multivariate logistic regression *** machine learning methods were used for model comparison,aiming to identify the optimal *** model’s performance was evaluated using the receiver operating characteristic curve[area under the curve(AUC)],calibration,and decision curve ***,the Kaplan-Meier(K-M)curve was used to evaluate the stratification effect of the model on patient *** Within this study,the most effective predictive performance for ER of post-hepatectomy HCC in the background of cirrhosis was demonstrated by a model that integrated radiomics features and clinical-radiologic *** the training cohort,this model attained an AUC of 0.844,while in the validation cohort,it achieved a value of *** K-M curves illustrated that the combined model not only facilitated risk stratification but also exhibited significant discriminatory ability concerning patients’*** The combined model,integrating both radiomics and clinical-radiologic characteristics,exhibited excellent performance in HCC with *** K-M curves assessing OS revealed statistically significant differences.

关键词： Machine learning Radiomics Hepatocellular carcinoma Cirrhosis early recurrence Overall survival Computed tomography Prognosis Risk factor Delta-radiomics

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Leveraging machine learning for early recurrence prediction in hepatocellular carcinoma:A step towards precision medicine

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World Journal of Gastroenterology 2024年第5期30卷 424-428页

作者： Abhimati Ravikulan Kamran Rostami epartment of Gastroenterology Palmerston North HospitalPalmerston North 4442New Zealand

The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative *** advent of machine learning provides a unique opportunity to harness vast datasets,identifying subtle patterns and factors that elude conventional prognostic *** learning models,equipped with the ability to analyse intricate relationships within datasets,have shown promise in predicting outcomes in various medical *** the context of HCC,the application of machine learning to predict early recurrence holds potential for personalized postoperative care *** editorial comments on the study carried out exploring the merits and efficacy of random survival forests(RSF)in identifying significant risk factors for recurrence,stratifying patients at low and high risk of HCC recurrence and comparing this to traditional COX proportional hazard models(CPH).In doing so,the study demonstrated that the RSF models are superior to traditional CPH models in predicting recurrence of HCC and represent a giant leap towards precision medicine.

关键词： Machine learning Artificial intelligence Hepatocellular carcinoma Hepatology early recurrence Liver resection

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Postoperative serum tumor markers-based nomogram predicting early recurrence for patients undergoing radical resections of pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3211-3223页

作者： Hang He Cai-Feng Zou Feng Yang Yang Di Chen Jin De-Liang Fu Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China

BACKGROUND early recurrence(ER)is associated with dismal outcomes in patients undergoing radical resection for pancreatic ductal adenocarcinoma(PDAC).Approaches for predicting ER will help clinicians in implementing individualized adjuvant *** serum tumor markers(STMs)are indicators of tumor progression and may improve current systems for predicting *** To establish an improved nomogram based on postoperative STMs to predict ER in *** We retrospectively enrolled 282 patients who underwent radical resection for PDAC at our institute between 2019 and *** and multivariate Cox regression analyses of variables with or without postoperative STMs,were performed to identify independent risk factors for ER.A nomogram was constructed based on the independent postoperative *** operating characteristic curve analysis was used to evaluate the area under the curve(AUC)of the *** analysis was performed using Kaplan-Meier survival plot and log-rank *** Postoperative carbohydrate antigen 19-9 and carcinoembryonic antigen levels,preoperative carbohydrate antigen 125 levels,perineural invasion,and pTNM stage III were independent risk factors for ER in *** postoperative STMs-based nomogram(AUC:0.774,95%CI:0.713-0.835)had superior accuracy in predicting ER compared with the nomogram without postoperative STMs(AUC:0.688,95%CI:0.625-0.750)(P=0.016).Patients with a recurrence nomogram score(RNS)>1.56 were at high risk for ER,and had significantly poorer recurrence-free survival[median:3.08 months,interquartile range(IQR):1.80-8.15]than those with RNS≤1.56(14.00 months,IQR:6.67-24.80),P<0.001).CONCLUSION The postoperative STMs-based nomogram improves the predictive accuracy of ER in PDAC,stratifies the risk of ER,and identifies patients at high risk of ER for tailored adjuvant therapies.

关键词： Nomogram Postoperative serum tumor markers early recurrence Predicting accuracy Adjuvant therapy Pancreatic ductal adenocarcinoma

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recurrence scoring system predicting early recurrence for patients with pancreatic ductal adenocarcinoma undergoing pancreatectomy and portomesenteric vein resection

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3185-3201页

作者： Hang He Cai-Feng Zou Yong-Jian Jiang Feng Yang Yang Di Ji Li Chen Jin De-Liang Fu Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China

BACKGROUND Pancreatectomy with concomitant portomesenteric vein resection(PVR)enables patients with portomesenteric vein(PV)involvement to achieve radical resection of pancreatic ductal adenocarcinoma,however,early recurrence(ER)is frequently *** To predict ER and identify patients at high risk of ER for individualized *** Totally 238 patients undergoing pancreatectomy and PVR were retrospectively enrolled and were allocated to the training or validating *** Cox and LASSO regression analyses were performed to construct serum recurrence score(SRS)based on 26 serum-derived ***-and multivariate Cox regression analyses of SRS and 18 clinicopathological variables were performed to establish a *** operating characteristic curve analysis was used to evaluate the predictive *** analysis was performed using Kaplan-Meier method and log-rank *** Independent serum-derived recurrence-relevant factors of LASSO regression model,including postoperative carbohydrate antigen 19-9,postoperative carcinoembryonic antigen,postoperative carbohydrate antigen 125,preoperative albumin(ALB),preoperative platelet to ALB ratio,and postoperative platelets to lymphocytes ratio,were used to construct SRS[area under the curve(AUC):0.855,95%CI:0.786–0.924].Independent risk factors of recurrence,including SRS[hazard ratio(HR):1.688,95%CI:1.075-2.652],pain(HR:1.653,95%CI:1.052-2.598),perineural invasion(HR:2.070,95%CI:0.827-5.182),and PV invasion(HR:1.603,95%CI:1.063-2.417),were used to establish the recurrence nomogram(AUC:0.869,95%CI:0.803-0.934).Patients with either SRS>0.53 or recurrence nomogram score>4.23 were considered at high risk for ER,and had poor long-term *** The recurrence scoring system unique for pancreatectomy and PVR,will help clinicians in predicting recurrence efficiently and identifying patients at high risk of ER for individualized therapy.

关键词： early recurrence Portomesenteric vein resection Pancreatic ductal adenocarcinoma recurrence score Nomogram

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Identifying timing and risk factors for early recurrence of resectable rectal cancer: A single center retrospective study

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2842-2852页

作者： Tsung-Jung Tsai Kai-Jyun Syu Xuan-Yuan Huang Yu Shih Liu Chang-Wei Chen Yen-Hang Wu Ching-Min Lin Yu-Yao Chang Division of Colon and Rectal Surgery Department of SurgeryChanghua Christian HospitalChanghua 50006TaiwanChina Department of Surgery Changhua Christian HospitalChanghua 50006TaiwanChina Department of Post-Baccalaureate Medicine College of MedicineNational Chung Hsing UniversityTaichung 402202TaiwanChina

BACKGROUND Colorectal cancer is a common malignancy and various methods have been introduced to decrease the possibility of *** recurrence(ER)is related to worse *** date,few observational studies have reported on the analysis of rectal ***,we reported on the timing and risk factors for the ER of resectable rectal cancer at our *** To analyze a cohort of patients with local and/or distant recurrence following the radical resection of the primary *** Data were retrospectively collected from the institutional database from March 2011 to January *** data at diagnosis,perioperative and postoperative data,and first recurrence were collected and *** was defined via receiver operating characteristic *** factors were evaluated using the Kaplan–Meier method and Cox proportional hazards *** We included 131 *** optimal cut off value of recurrence-free survival(RFS)to differentiate between ER(n=55,41.9%)and late recurrence(LR)(n=76,58.1%)was 8 *** median post-recurrence survival(PRS)of ER and LR was 1.4 mo and 2.9 mo,respectively(P=0.008)but PRS was not strongly associated with RFS(R^(2)=0.04).Risk factors included age≥70 years[hazard ratio(HR)=1.752,P=0.047],preoperative concurrent chemoradiotherapy(HR=3.683,P9 d(HR=0.441,P=0.006).CONCLUSION RFS of 8 mo was the optimal cut-off *** ER was not associated with PRS,it was still related to prognosis;thus,intense surveillance is recommended.

关键词： Rectal cancer early recurrence Prognosis Post-recurrence survival

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Preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after curative intent surgical resection

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Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 450-455页

作者： Nam Hee Kim Hong Joo Kim Division of Gastroenterology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

Background: Postoperative early recurrence(ER) in patients with pancreatic ductal adenocarcinoma(PDAC) is frequently encountered after curative intent surgery. Nonetheless, clinical significance and risk factors of ER after surgery for PDAC have not been extensively investigated. The aim of this study was to determine preoperative risk predictors for ER in patients with PDAC after upfront surgery. Methods: Eighty-one consecutive patients with PDAC who underwent curative intent surgical resection at Kangbuk Samsung Hospital between January 2004 and May 2015 were enrolled. ER was defined as tumor relapse within 6 months after surgery. Results: ER occurred in 26 patients(32.1%), whereas 49 patients(60.5%) had late recurrence( ≥ 6 months after surgery), and 6 patients had no recurrence(7.4%). Univariate analysis showed that C-reactive protein(CRP) > 3.0 mg/dL, modified Glasgow prognostic score(mGPS) = 2, decrease of total lymphocyte count by > 50% of baseline value in the preoperative period, prognostic nutritional index(PNI) 3.0 mg/dL, decrease of total lymphocyte count by > 50% of baseline value, and preoperative SUVmax were significant and independent contributors of ER in patients with resectable PDAC who underwent curative intent surgery. Conclusions: Postoperative ER for resectable PDAC was frequent with poor prognosis after curative intent upfront surgery. It is reasonable to suggest that there is a subgroup of resectable PDAC patients at highrisk of ER and neoadjuvant therapy should be considered in these patients in a clinical trial setting.

关键词： early recurrence Pancreatic ductal adenocarcinoma Preoperative risk factors C-reactive protein Maximum standardized uptake value

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α-fetoprotein,vascular endothelial growth factor receptor-1 and early recurrence of hepatoma

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World Journal of Gastroenterology 2012年第4期18卷 340-348页

作者： Toshiya Kamiyama Masato Takahashi Kazuaki Nakanishi Hideki Yokoo Hirofumi Kamachi Nozomi Kobayashi Michitaka Ozaki Satoru Todo Department of General Surgery Graduate School of MedicineHokkaido University Department of Transplantation Surgery Graduate School of MedicineHokkaido University Department of Molecular Surgery Graduate School of MedicineHokkaido University

AIM:To investigate whether α-fetoprotein (AFP) and vascular endothelial growth factor receptor (VEGFR)-1 correlate with early recurrence of hepatoma/hepatocel-lular carcinoma (HCC).METHODS:From 2000 to 2005,114 consecutive pa-tients with HCC underwent primary curative *** mean age was 60.7 (8.7) years and 94 patients were *** median follow-up period was 71.2 mo (range:43-100 mo).Immediately prior to commencing laparotomy,5 mL bone marrow was aspirated from thesternum and collected in citrate-coated test *** initial 2 mL of bone marrow aspirate was discarded in each *** mRNA and VEGFR-1 mRNA in the bone marrow and peripheral blood (BM-and PH-AFP mRNA and BM-and PH-VEGFR-1 mRNA,respectively) were measured by real-time quantitative reverse transcription polymerase chain *** normal controls,VEGFR-1 mRNA in the bone marrow and peripheral blood was also measured in 11 living liver *** data were evaluated for any correlation with early recurrence,comparing clinical and pathological ***:The cut-off value of the BM-AFP mRNA and PH-AFP mRNA level in patients with HCC was set at 1.92 × 10-7 and zero,respectively,based on data from the controls.A total of 34 (29.8%) and six (5.4%) patients were positive for BM-AFP mRNA and PH-AFP mRNA,*** BM-VEGFR-1 mRNA levels in all HCC patients were higher than those in the normal con-trols,and this was the case also for *** 25-percentile values for the BM-and PH-VEGFR-1 mRNA in HCC patients were used as the cut-off values for assigning the patients into two groups based on these transcript *** High group for BM-VEG-FR-1 mRNA contained 81 (71.1%) HCC cases and the Low group was assigned 33 (28.9%) *** numbers for PH-VEGFR-1mRNA were 78 (75.0%) and 26 (25.0%),*** recurred in 80 patients;in the remnant liver in 48 cases,in the remnant liver and remote tissue in 20,and in the remote tissue alone in ***-AFP mRNA-positive cases

关键词： α-fetoprotein Vascular endothelial growth factor receptor-i mRNA early recurrence Hepatocellular carcinoma

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Patients with early recurrence of hepatocellular carcinoma have poor prognosis

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 279-288页

作者： Tomoki Kobayashi Hiroshi Aikata Tsuyoshi Kobayashi Hideki Ohdan Koji Arihiro Kazuaki Chayama Department of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima Japan Department of Anatomical Pathology Hiroshima University Hospital Hiroshima Japan Department of Gastroenterological and Transplant Surgery Applied Life Sciences Institute of Biomedical and Health Sciences Hiroshima University Hiroshima Japan Liver Research Project Center Hiroshima University Hiroshima Japan

BACKGROUND： early recurrence （ER） after hepatic resection （HR） is a poor prognostic factor for patients with hepatocellular carcinoma （HCC）. This study aimed to identify the clinico- pathological features, outcomes, and risk factors for ER after HR for small HCC in order to clarify the reasons why ER is a worse recurrence pattern. METHODS： We retrospectively examined 130 patients who underwent HR for small HCC （___30 mm）. recurrence was clas- sifted into ER （〈2 years） and late recurrence （LR）（_〉2 years）. The clinicopathological features, outcomes, and risk factors for ER were analyzed by multivariate analysis. RESULTS： ER was observed in 39 patients （30.0%）. The sur- vival rate of the ER group was significantly lower than that of the LR group （P〈0.005）, and ER was an independent prognos- tic factor for poor survival （P=0.0001）. The ER group had a significantly higher frequency （P=0.0039） and shorter interval （P=0.027） of development to carcinoma beyond the Milan criteria （DBMC） compared with the LR group, and ER was an independent risk factor for DBMC （P〈0.0001）. Multi-nodularity, non-simple nodular type, and microvascular invasion were independent predictors for ER （P=0.012, 0.010, and 0.019, respectively）.CONCLUSIONS： ER was a highly malignant recurrence pattern associated with DBMC and subsequent poor survival after HR for small HCC. Multi-nodularity, non-simple nodular type, and microvascular invasion predict ER, and taking these factors into consideration may be useful for the decision of the treatment strategy for small HCC after HR.

关键词： early recurrence small hepatocellular carcinoma risk factors beyond the Milan criteria

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Prediction of early recurrence of hepatocellular carcinoma after liver transplantation based on computed tomography radiomics nomogram

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Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 543-550页

作者： Jing-Wei Zhao Xin Shu Xiao-Xia Chen Jia-Xiong Liu Mu-Qing Liu Ju Ye Hui-Jie Jiang Gui-Sheng Wang Department of Radiology the Third Medical CenterChinese PLA General HospitalThe Training Site for Postgraduate of Jinzhou Medical UniversityBeijing 100039China Department of Radiology the Third Medical CenterChinese PLA General HospitalBeijing 100039China Medical School of Chinese PLA Beijing 100853China Department of Radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China

Background:early recurrence results in poor prognosis of patients with hepatocellular carcinoma(HCC)after liver transplantation(LT).This study aimed to explore the value of computed tomography(CT)-based radiomics nomogram in predicting early recurrence of patients with HCC after ***:A cohort of 151 patients with HCC who underwent LT between December 2013 and July 2019 were retrospectively enrolled.A total of 1218 features were extracted from enhanced CT *** least absolute shrinkage and selection operator algorithm(LASSO)logistic regression was used for dimension reduction and radiomics signature *** clinical model was constructed after the analysis of clin-ical factors,and the nomogram was constructed by introducing the radiomics signature into the clinical *** predictive performance and clinical usefulness of the three models were evaluated using re-ceiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),***-bration curves were plotted to assess the calibration of the ***:There were significant differences in radiomics signature among early recurrence patients and non-early recurrence patients in the training cohort(Pearly recurrence in patients with HCC after LT.

关键词： Radiomics Nomogram Liver transplantation early recurrence Hepatocellular carcinoma

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Deep learning-based radiomics based on contrast-enhanced ultrasound predicts early recurrence and survival outcome in hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2022年第12期14卷 2380-2392页

作者： Zhe Huang Zhu Shu Rong-Hua Zhu Jun-Yi Xin Ling-Ling Wu Han-Zhang Wang Jun Chen Zhi-Wei Zhang Hong-Chang Luo Kai-Yan Li Department of Medical Ultrasound Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Institute of Hepato-pancreato-bililary Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina PDx Advanced Applications GE HealthcareShanghai 200020China

BACKGROUND Hepatocellular carcinoma(HCC)is the most common primary liver *** To predict early recurrence(ER)and overall survival(OS)in patients with HCC after radical resection using deep learning-based radiomics(DLR).METHODS A total of 414 consecutive patients with HCC who underwent surgical resection with available preoperative grayscale and contrast-enhanced ultrasound images were *** clinical,DLR,and clinical+DLR models were then designed to predict ER and *** The DLR model for predicting ER showed satisfactory clinical benefits[area under the curve(AUC=0.819 and 0.568 in the training and testing cohorts,respectively)],similar to the clinical model(AUC=0.580 and 0.520 in the training and testing cohorts,respectively;P>0.05).The C-index of the clinical+DLR model in the prediction of OS in the training and testing cohorts was 0.800 and 0.759,*** clinical+DLR model and the DLR model outperformed the clinical model in the training and testing cohorts(Precurrence was associated with improved survival(hazard ratio=7.895,P=0.005).CONCLUSION Compared to the clinical model,the clinical+DLR model significantly improves the accuracy of predicting OS in HCC patients after radical resection.

关键词： Hepatocellular carcinoma Deep learning Overall survival early recurrence Contrast-enhanced ultrasound

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