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Radiomics model based on contrast-enhanced computed tomography to predict early recurrence in patients with hepatocellular carcinoma after radical resection

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World Journal of Gastroenterology 2023年第26期29卷 4186-4199页

作者： Shu-Qun Li Li-Li Su Ting-Feng Xu Li-Ying Ren Dong-Bo Chen Wan-Ying Qin Xuan-Zhi Yan Jia-Xing Fan Hong-Song Chen Wei-Jia Liao Laboratory of Hepatobiliary and Pancreatic Surgery The Affiliated Hospital of Guilin Medical UniversityGuilin 541001Guangxi Zhuang Autonomous RegionChina Department of Clinical Laboratory Nanxishan Hospital of Guangxi Zhuang Autonomous RegionGuilin 541002Guangxi Zhuang Autonomous RegionChina Peking University People’s Hospital Peking University Hepatology InstituteBeijing Key Laboratory of Hepatitis C and Immunotherapy for Liver DiseaseBeijing 100091China

BACKGROUND Radical resection remains an effective strategy for patients with hepatocellular carcinoma(HCC).Unfortunately,the postoperative early recurrence(recurrence within 2 years)rate is still *** To develop a radiomics model based on preoperative contrast-enhanced computed tomography(CECT)to evaluate early recurrence in HCC patients with a single *** We enrolled a total of 402 HCC patients from two centres who were diagnosed with a single tumour and underwent radical ***,the features from the portal venous and arterial phases of CECT were extracted based on the region of interest,and the early recurrence-related radiomics features were selected via the least absolute shrinkage and selection operator proportional hazards model(LASSO Cox)to determine radiomics scores for each ***,the clinicopathologic data were combined to develop a model to predict early recurrence by Cox ***,we evaluated the prediction performance of this model by multiple *** A total of 1915 radiomics features were extracted from CECT images,and 31 of them were used to determine the radiomics scores,which showed a significant difference between the early recurrence and nonearly recurrence *** and multivariate Cox regression analyses showed that radiomics scores and serum alphafetoprotein were independent indicators,and they were used to develop a combined model to predict early *** area under the receiver operating characteristic curve values for the training and validation cohorts were 0.77 and 0.74,respectively,while the C-indices were 0.712 and 0.674,*** calibration curves and decision curve analysis showed satisfactory accuracy and clinical ***-Meier curves based on recurrence-free survival and overall survival showed significant *** The preoperative radiomics model was shown to be effective for predicting early recurrence among HCC patients with a single tum

关键词： Hepatocellular carcinoma Contrast-enhanced computed tomography Radiomics early recurrence

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A predictive model for early recurrence of colorectal-cancer liver metastases based on clinical parameters

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Gastroenterology Report 2021年第3期9卷 241-251,I0002页

作者： Siqi Dai Yao Ye Xiangxing Kong Jun Li Kefeng Ding Department of Colorectal Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangP.R.China Cancer Institute(Key Laboratory of Cancer Prevention and Intervention China National Ministry of EducationKey Laboratory of Molecular Biology in Medical SciencesZhejiang ProvinceChina)The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangP.R.China

Background:The prognosis for patients with colorectal-cancer liver metastases(CRLM)after curative surgery remains poor and shows great *** recurrence,defined as tumor recurrence within 6 months of curative surgery,is associated with poor survival,requiring earlier detection and *** study aimed to develop and validate a bedside model based on clinical parameters to predict early recurrence in CRLM patients and provide insight into post-operative surveillance *** and methods:A total of 202 consecutive CRLM patients undergoing curative surgeries between 2012 and 2019 were retrospectively enrolled and randomly assigned to the training(n=150)and validation(n=52)*** information and radiological,pathological,and laboratory findings were extracted from medical *** factors for early recurrence were identified via a multivariate logistic-regression model to develop a predictive nomogram,which was validated for discrimination,calibration,and clinical ***:Liver-metastases number,lymph-node suspicion,neurovascular invasion,colon/rectum location,albumin and post-operative carcinoembryonic antigen,and carbohydrate antigen 19–9 levels(CA19–9)were independent predictive factors and were used to construct the nomogramfor early recurrence after curative *** area under the curve was 0.866 and 0.792 for internal and external validation,*** model significantly outperformed the clinical risk score and Beppu’s model in our data *** the lift curve,the nomogram boosted the detection rate in post-operative surveillance by two-fold in the top 30%high-risk ***:Our model for early recurrence in CRLM patients after curative surgeries showed superior performance and could aid in the decision-making for selective follow-up strategies.

关键词： colorectal cancer liver metastases early recurrence prediction model post-operative surveillance

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A simple scoring system to predict early recurrence of Bismuth–Corlette type IV perihilar cholangiocarcinoma

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Gastroenterology Report 2019年第5期7卷 345-353,I0002页

作者： Ding-Zhong Peng Jiong Lu Bei Li Hai-Jie Hu Xi-Wen Ye Xian-Ze Xiong Nan-Sheng Cheng Department of biliary surgery West China Hospital of Sichuan UniversityChengduSichuanP.R.China

Background:early recurrence has been reported to be predictive of a poor prognosis for patients with perihilar cholangiocarcinoma(pCCA)after *** objective of our study was to construct a useful scoring system to predict early recurrence for Bismuth–Corlette type IV pCCA patients in clinic and to investigate the value of early recurrence in directing post-operative surveillance and adjuvant ***:In total,244 patients who underwent radical resection for type IV pCCA were *** on clinicopathological characteristics,perioperative details and survival outcomes were *** curves were generated using the Kaplan–Meier *** and multivariate logistic-regression models were used to identify factors associated with early ***:Twenty-one months was defined as the cutoff point to distinguish between early and late *** and multivariate analysis revealed that CA19-9 level>200 U/mL,R1 resection margin,higher N category and positive lymphovascular invasion were independent predictors of early *** scoring system was constructed *** early-recurrence rates of patients with scores of 0,1,2,3,4,and 5 were 23.9%,38.7%,60.0%,78.6%,83.4%,and 100%,*** therapy was significantly associated with higher overall survival rate for patients with early recurrence,but not for those with late *** in the early-recurrence group with scores2 had better prognoses after adjuvant ***:A simple scoring system using CA19-9 level,N category,resection margin and lymphovascular invasion status could predict early recurrence,and thus might direct post-operative surveillance and adjuvant therapy for patients with type IV pCCA.

关键词： early recurrence Bismuth–Corlette classification perihilar cholangiocarcinoma

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Development of a machine learning model to predict early recurrence for hepatocellular carcinoma after curative resection

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Hepatobiliary Surgery and Nutrition 2022年第2期11卷 176-187,I0001-I0006页

作者： Jianxing Zeng Jinhua Zeng Kongying Lin Haitao Lin Qionglan Wu Pengfei Guo Weiping Zhou Jingfeng Liu Department of Hepatic Surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina The First Affiliated Hospital of Fujian Medical University FuzhouChina Southeast Big Data Institute of Hepatobiliary Health Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina The Liver Center of Fujian Province Fujian Medical UniversityFuzhouChina Department of Pathology Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina The Third Department of Hepatic Surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghaiChina

Background:early recurrence is common for hepatocellular carcinoma(HCC)after surgical resection,being the leading cause of ***,the COX proportional hazard(CPH)models based on linearity assumption have been used to predict early recurrence,but predictive performance is *** learning models offer a novel methodology and have several advantages over CPH ***,the purpose of this study was to compare random survival forests(RSF)model with CPH models in prediction of early recurrence for HCC patients after curative ***:A total of 4,758 patients undergoing curative resection from two medical centers were *** features including age,gender,etiology,platelet count,albumin,total bilirubin,AFP,tumor size,tumor number,microvascular invasion,macrovascular invasion,Edmondson-Steiner grade,tumor capsular,satellite nodules and liver cirrhosis were used to construct the RSF model in training ***,calibration,clinical usefulness and overall performance were assessed and compared with other ***:Five hundred survival trees were used to generate the RFS *** five highest Variable Importance(VIMP)were tumor size,macrovascular invasion,microvascular invasion,tumor number and *** training,internal and external validation cohort,the C-index of RSF model were 0.725[standard errors(SE)=0.005],0.762(SE=0.011)and 0.747(SE=0.016),respectively;the Gönen&Heller’s K of RSF model were 0.684(SE=0.005),0.711(SE=0.008)and 0.697(SE=0.014),respectively;the time-dependent AUC(2 years)of RSF model were 0.818(SE=0.008),0.823(SE=0.014)and 0.785(SE=0.025),*** RSF model outperformed early recurrence after surgery for liver tumor(ERASL)model,Korean model,American Joint Committee on Cancer tumor-node-metastasis(AJCC TNM)stage,Barcelona Clinic Liver Cancer(BCLC)stage and Chinese *** RSF model is capable of stratifying patients into three different risk groups(low-risk,intermediate-risk,high-risk gro

关键词： Hepatocellular carcinoma(HCC) liver resection early recurrence machine learning individualized prediction

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Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1423-1435页

作者： Sarang Hong Ki Byung Song Dae Wook Hwang Jae Hoon Lee Woohyung Lee Eunsung Jun Jaewoo Kwon Yejong Park Seo Young Park Naru Kim Dakyum Shin Hyeyeon Kim Minkyu Sung Yunbeom Ryu Song Cheol Kim Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryAsan Medical CenterSeoul 05505South Korea Department of Surgery Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 03181South Korea Department of Statistics and Data Science Korea National Open UniversitySeoul 03087South Korea Department of Surgery Uijeongbu St.Mary's HospitalCollege of MedicineGyeonggido 11765South Korea

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor *** a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,who are expected to have a better prognosis,often experience ***,it is important to identify the risk factors for early recurrence and to develop an adequate treatment *** To evaluate the predictive factors associated with the early recurrence of earlystage *** This study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April *** recurrence was defined as a diagnosis of recurrence within 6 mo of *** optimal cutoff values were determined by receiver operating characteristic(ROC)*** and multivariate analyses were performed to identify the risk factors for early *** Of the 407 patients,98 patients(24.1%)experienced early disease recurrence:26(26.5%)local and 72(73.5%)distant *** total,253(62.2%)patients received adjuvant *** ROC curve analysis,the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9(CA 19-9)levels and tumor size,*** the 181 patients with CA 19-9 level>70 U/mL,59(32.6%)had early recurrence,compared to 39(17.4%)of 226 patients with CA 19-9 level≤70 U/mL(P70 U/mL(P=0.006),tumor size>2.85 cm(P=0.004),poor differentiation(P=0.008),and non-adjuvant chemotherapy(P=0.025)were significant risk factors for early recurrence in early-stage *** Elevated CA 19-9 level(cutoff value>70 U/mL)can be a reliable predictive factor for early recurrence in early-stage *** adjuvant chemotherapy can prevent early recurrence,it should be recommended for patients susceptible to early recurrence.

关键词： Pancreatic ductal adenocarcinoma early recurrence Upfront surgery Carbohydrate antigen 19-9 Adjuvant chemotherapy

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early recurrence of a Cardiac Malignant Fibrous Histiocytoma

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World Journal of Cardiovascular Surgery 2013年第5期3卷 139-142页

作者： Laura Reija Lopez Angela Granda Bauza Jose Manuel Martínez Cereijo Jose Rubio Alvarez Belén Adrio Nazar Juan Sierra Quiroga Complexo Hospitalario Universitario de Santiago de Compostela A CorunaSpain

Malignant fibrous histiocytoma (MFH) is a rare tumor of the heart and the patients with these tumors usually have a poor prognosis. We report a case of MFH with an origin from the left superior pulmonary vein, involving the left atrium and protruding through the mitral valve, which needed urgent surgery. Complete resection was performed but local recurrence was detected one month later.

关键词： Malignant Fibrous Histiocytoma early recurrence

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The Relationship of Elevated Preoperative Serum CA19-9 Levels and the early recurrence of Single Small Hepatocellular Carcinoma

The Relationship of Elevated Preoperative Serum CA19-9 Level...

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2021年中国肿瘤标志物学术大会暨第十五届肿瘤标志物青年科学家论坛

作者： Shaohua Ren Tianqiang Song Tianjin Medical University Cancer Institute and Hospital

Background : Determining the risk factors for the recurrence of single small HCC(≤ 3 cm) may contribute to the implementation of additional treatment strategies in clinical ***: A total of 276 patients with single small primary HCC(≤ 3 cm) who received initial treatment from September 2010 to September 2019 were retrospectively enrolled in the primary cohort through random resolution to establish a nomogram. The remaining 137 patients were used to verify the accuracy of the ***: The median RFS for the primary and the validation cohorts were 43.0 and 51.0 months,respectively. The multivariate analysis showed that age, hepatitis, preoperative CA19-9 level, and Child-Pugh score were independent risk factors for recurrence-free survival. On the basis of these four variables, the nomogram was developed. Patients with normal preoperative CA19-9 levels had better RFS than those with abnormal preoperative CA19-9 levels. Especially, among the AFP-negative patients, those with normal preoperative CA19-9 levels had better RFS than those with abnormal preoperative CA19-9 ***: The preoperative CA19-9 level is an independent risk factor affecting the prognosis of patients with one small HCC, especially among the AFP-negative patients, and should be given full attention in clinical practice.

关键词： small hepatocellular carcinoma early recurrence nomogram CA19-9

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Development of a machine learning-based model for predicting risk of early postoperative recurrence of hepatocellular carcinoma

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World Journal of Gastroenterology 2023年第43期29卷 5804-5817页

作者： Yu-Bo Zhang Gang Yang Yang Bu Peng Lei Wei Zhang Dan-Yang Zhang Department of Hepatobiliary Surgery General Hospital of Ningxia Medical UniversityYinchuan 750003Ningxia Hui Autonomous RegionChina Department of Hepatobiliary Surgery People's Hospital of Ningxia Hui Autonomous RegionYinchuan 750003Ningxia Hui Autonomous RegionChina

BACKGROUND Surgical resection is the primary treatment for hepatocellular carcinoma(HCC).However,studies indicate that nearly 70%of patients experience HCC recurrence within five years following *** earlier the recurrence,the worse the *** studies on postoperative recurrence primarily rely on postoperative pathology and patient clinical data,which are ***,developing a new pre-operative prediction model for postoperative recurrence is crucial for guiding individualized treatment of HCC patients and enhancing their *** To identify key variables in pre-operative clinical and imaging data using machine learning algorithms to construct multiple risk prediction models for early postoperative recurrence of *** The demographic and clinical data of 371 HCC patients were collected for this retrospective *** data were randomly divided into training and test sets at a ratio of 8:*** training set was analyzed,and key feature variables with predictive value for early HCC recurrence were selected to construct six different machine learning prediction *** model was evaluated,and the bestperforming model was selected for interpreting the importance of each ***,an online calculator based on the model was generated for daily clinical *** Following machine learning analysis,eight key feature variables(age,intratumoral arteries,alpha-fetoprotein,preoperative blood glucose,number of tumors,glucose-to-lymphocyte ratio,liver cirrhosis,and pre-operative platelets)were selected to construct six different prediction *** XGBoost model outperformed other models,with the area under the receiver operating characteristic curve in the training,validation,and test datasets being 0.993(95%confidence interval:0.982-1.000),0.734(0.601-0.867),and 0.706(0.585-0.827),*** curve and decision curve analysis indicated that the XGBoost model also had good predictive performance and clin

关键词： Machine learning Hepatocellular carcinoma early recurrence Risk prediction models Imaging features Clinical features

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Impact of pathological response after preoperative transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion and early tumor recurrence in hepatocellular carcinoma:a multicenter propensity score matching analysis

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Hepatobiliary Surgery and Nutrition 2022年第3期11卷 386-399页

作者： Yun Yang Zheng Dang Peng Lu Youwen Qian Kongying Lin Zeya Pan Wan Yee Lau Weiping Zhou The Third Department of Hepatic Surgery Eastern Hepatobiliary Surgery HospitalShanghaiChina Department of Hepatobiliary Surgery 940 Hospital of PLA Joint Logistic Support ForceLanzhouChina Department of Hepatobiliary Surgery Hainan Hospital of Chinese PLA General HospitalSanyaChina Department of Pathology Eastern Hepatobiliary Surgery HospitalShanghaiChina Department of Hepatopancreatobiliary Surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina Faculty of Medicine the Chinese University of Hong KongHong KongChina Key Laboratory of Signaling Regulation and Targeting Therapy of Liver Cancer(SMMU) Ministry of EducationShanghaiChina Shanghai Key Laboratory of Hepatobiliary Tumor Biology(EHBH) ShanghaiChina

Background:To study the influence of pathological responses(PR)after transcatheter arterial chemoembolization(TACE)on incidences of microvascular invasion(MVI)and early recurrence in hepatocellular carcinoma(HCC)***:Between 2013 to 2015,consecutive HCC patients who underwent liver resection with“curative”intent at three hospitals were enrolled in this *** with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI,early recurrence rates and patterns of recurrence before and after propensity score matching(PSM).Results:Of 1,970 patients,737 patients who received preoperative TACE were divided into three groups according to the areas of PR:≥90%(n=226),60-90%(n=447),andearly recurrence(HR,0.742;95%CI,0.561-0.963,P=0.032);while PRearly recurrence(HR,1.428;95%CI,1.095-1.929;P=0.009).Furthermore,patients with PRrecurrences involving multiple hepatic segments when compared with patients without preoperative ***:This study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor *** with PRearly and multiple tumor recurrences.

关键词： Hepatocellular carcinoma(HCC) transcatheter arterial chemoembolization(TACE) pathological response microvascular invasion(MVI) early recurrence

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Risk of early hepatocellular carcinoma recurrence following liver resection: arbitrary specification or possible target to improve outcome?

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 745-748页

作者： Arno Kornberg Department of Surgery Klinikum rechts der IsarSchool of MedicineTechnical University of MunichMunichGermany

Data from the literature favour liver transplantation(LT)as best curative-intent treatment in patients with early-stage hepatocellular carcinoma(HCC)arising from cirrhosis,as this approach targets both malignancy and the underlying cancerogenic *** strictly adhering to well-defined morphometric tumor burden limits,such as the Milan criteria,excellent recurrence-free survival(RFS)rates beyond 70%at 5 years may be achieved after ***,growing donor liver shortage has significantly increased waiting times and thereby risk of tumor-related dropout from the waiting list,ultimately resulting in inferior survival *** recent years,this critical situation further aggravated by growing evidence that beyond Milan patients may also benefit from LT,when being successfully downstaged by neoadjuvant locoregional interventions like transarterial chemoembolization(TACE)or radiofrequency ablation(RFA)(1).Therefore,even though being associated with an extraordinary risk of HCC recurrence accounting for 50%to 70%,upfront liver resection(LR)still represents the preferred surgical procedure in patients with resectable tumor stage,especially in those who do not suffer from severe portal hypertension.

关键词： Liver resection(LR) hepatocellular carcinoma(HCC) early recurrence late recurrence

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