Development and validation of a nomogram for predicting microvascular invasion and evaluating the efficacy of postoperative adjuvant transarterial chemoembolization

Tu, Shuju6; He, Yongzhu4; Shu, Xufeng2; Bao, Shiyun4; Wu, Zhao3; Cui, Lifeng5; Luo, Laihui2; Li, Yong2; He, Kun1

2024-09-15

10.1016/j.heliyon.2024.e36770

HELIYON   影响因子和分区

2405-8440

Background and aim: Accurately predicting microvascular invasion (MVI) before surgery is beneficial for surgical decision-making, and some high-risk hepatocellular carcinoma (HCC) patients may benefit from postoperative adjuvant transarterial chemoembolization (PA-TACE). The purpose of this study was to develop and validate a novel nomogram for predicting MVI and assessing the survival benefits of selectively receiving PA-TACE in HCC patients. Methods: The 1372 HCC patients who underwent hepatectomy at four medical institutions were randomly divided into training and validation datasets according to a 7:3 ratio. We developed and validated a nomogram for predicting MVI using preoperative clinical data and further evaluated the survival benefits of selective PA-TACE in different risk subgroups. Results: The nomogram for predicting MVI integrated alpha-fetoprotein, tumor diameter, tumor number, and tumor margin, with an area under the curve of 0.724, which was greater than that of any single predictive factor. The calibration curve, decision curve, and clinical impact curve demonstrated that the nomogram had strong predictive performance. Risk stratification based on the nomogram revealed that patients in the low-risk group did not achieve better DFS and OS with PA-TACE (all p > 0.05), while patients in the medium-to-high risk groups could benefit from higher DFS (Medium-risk, p = 0.039; High-risk, p = 0.027) and OS (Medium-risk, p = 0.001; High-risk, p = 0.019) with PA-TACE. Conclusions: The nomogram predicting MVI demonstrated strong predictive performance, and its risk stratification aided in identifying different subgroups of HCC patients who may benefit from PA-TACE with improved survival outcomes.

Microvascular invasion Hepatocellular carcinoma Postoperative Transarterial chemoembolization Hepatectomy Nomogram

SCI

英语

其他

Zhongshan Science and Technology Plan Project of Guangdong Province[2021B1040] ; Key research and development projects of Jiangxi Provincial Department of Science and Technology[20202BBGL73092] ; Natural Science Foundation of Jiangxi Provincial[20171BAB205064] ; National Natural Science Foundation of China[81860432]

Science & Technology - Other Topics

Multidisciplinary Sciences

WOS:001313208900001

CELL PRESS

Web of Science

1.Sun Yat Sen Univ, Zhongshan Peoples Hosp, Zhongshan Hosp, Dept Hepatobiliary Surg, 2 Sunwen East Rd, Zhongshan 528400, Guangdong, Peoples R China
2.Nanchang Univ, Affiliated Hosp 1, Clin Med Coll 1, Dept Gen Surg, Nanchang 330006, Jiangxi, Peoples R China
3.Nanchang Univ, Dept Gen Surg, Affiliated Hosp 2, Clin Med Coll 2, Nanchang 330006, Jiangxi, Peoples R China
4.Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2,Affiliated Hosp 1,Div Hepatobiliar, Shenzhen 518020, Guangdong, Peoples R China
5.Maoming Peoples Hosp, Maoming 525000, Guangdong, Peoples R China
6.Xiantao First Peoples Hosp, Dept HepatobiliarySurgery, Xiantao 433000, Hubei, Peoples R China

Tu, Shuju,He, Yongzhu,Shu, Xufeng,et al. Development and validation of a nomogram for predicting microvascular invasion and evaluating the efficacy of postoperative adjuvant transarterial chemoembolization[J]. HELIYON,2024,10(17).

Tu, Shuju.,He, Yongzhu.,Shu, Xufeng.,Bao, Shiyun.,Wu, Zhao.,...&He, Kun.(2024).Development and validation of a nomogram for predicting microvascular invasion and evaluating the efficacy of postoperative adjuvant transarterial chemoembolization.HELIYON,10(17).

Tu, Shuju,et al."Development and validation of a nomogram for predicting microvascular invasion and evaluating the efficacy of postoperative adjuvant transarterial chemoembolization".HELIYON 10.17(2024).