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Multi-Institutional Development and External Validation of a Nomogram for Prediction of Extrahepatic Recurrence After Curative-Intent Resection for Hepatocellular Carcinoma

2021Journal article Open access
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dc.contributor.authorWei, T
dc.contributor.authorZhang, XF
dc.contributor.authorXue, F
dc.contributor.authorBagante, F
dc.contributor.authorRatti, F
dc.contributor.authorPinto Marques, H
dc.contributor.authorSilva, S
dc.contributor.authorSoubrane, O
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, GA
dc.contributor.authorPopescu, I
dc.contributor.authorGrigorie, R
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorWorkneh, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorHugh, T
dc.contributor.authorAldrighetti, L
dc.contributor.authorEndo, I
dc.contributor.authorPawlik, TM
dc.date.accessioned2022-11-07T15:21:26Z
dc.date.available2022-11-07T15:21:26Z
dc.date.issued2021
dc.description.abstractBackgrounds: Extrahepatic recurrence of hepatocellular carcinoma (HCC) after surgical resection is associated with unfavorable prognosis. The objectives of the current study were to identify the risk factors and develop a nomogram for the prediction of extrahepatic recurrence after initial curative surgery. Methods: A total of 635 patients who underwent curative-intent resection for HCC between 2000 and 2017 were identified from an international multi-institutional database. The clinicopathological characteristics, risk factors, and long-term survival of patients with extrahepatic recurrence were analyzed. A nomogram for the prediction of extrahepatic recurrence was established and validated in 144 patients from an external cohort. Results: Among the 635 patients in the derivative cohort, 283 (44.6%) experienced recurrence. Among patients who recurred, 80 (28.3%) patients had extrahepatic ± intrahepatic recurrence, whereas 203 (71.7%) had intrahepatic recurrence only. Extrahepatic recurrence was associated with more advanced initial tumor characteristics, early recurrence, and worse prognosis versus non-extrahepatic recurrence. A nomogram for the prediction of extrahepatic recurrence was developed using the β-coefficients from the identified risk factors, including neutrophil-to-lymphocyte ratio, multiple lesions, tumor size, and microvascular invasion. The nomogram demonstrated good ability to predict extrahepatic recurrence (c-index: training cohort 0.786; validation cohort: 0.845). The calibration plots demonstrated good agreement between estimated and observed extrahepatic recurrence (p = 0.658). Conclusions: An externally validated nomogram was developed with good accuracy to predict extrahepatic recurrence following curative-intent resection of HCC. This nomogram may help identify patients at high risk of extrahepatic recurrence and guide surveillance protocols as well as adjuvant treatments.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol. 2021 Nov;28(12):7624-7633.pt_PT
dc.identifier.doi10.1245/s10434-021-10142-7pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4264
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerlinkpt_PT
dc.subjectCarcinoma, Hepatocellular* / surgerypt_PT
dc.subjectHepatectomypt_PT
dc.subjectHCC CHBPTpt_PT
dc.subjectHumans
dc.subjectLiver Neoplasms* / surgery
dc.subjectNeoplasm Recurrence, Local / diagnosis
dc.subjectNeoplasm Recurrence, Local / surgery
dc.subjectNomograms
dc.subjectPrognosis
dc.subjectRetrospective Studies
dc.titleMulti-Institutional Development and External Validation of a Nomogram for Prediction of Extrahepatic Recurrence After Curative-Intent Resection for Hepatocellular Carcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage7633pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage7624pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume28pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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