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A Novel Online Calculator to Predict Risk of Microvascular Invasion in the Preoperative Setting for Hepatocellular Carcinoma Patients Undergoing Curative-Intent Surgery

2023-02Journal article Open access
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dc.contributor.authorEndo, Y
dc.contributor.authorAlaimo, L
dc.contributor.authorLima, H
dc.contributor.authorMoazzam, Z
dc.contributor.authorRatti, F
dc.contributor.authorPinto Marques, H
dc.contributor.authorSoubrane, O
dc.contributor.authorLam, V
dc.contributor.authorKitago, M
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
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, T
dc.date.accessioned2024-07-30T15:08:51Z
dc.date.available2024-07-30T15:08:51Z
dc.date.issued2023-02
dc.description.abstractBackground: The presence of microvascular invasion (MVI) has been highlighted as an important determinant of hepatocellular carcinoma (HCC) prognosis. We sought to build and validate a novel model to predict MVI in the preoperative setting. Methods: Patients who underwent curative-intent surgery for HCC between 2000 and 2020 were identified using a multi-institutional database. Preoperative predictive models for MVI were built, validated, and used to develop a web-based calculator. Results: Among 689 patients, MVI was observed in 323 patients (46.9%). On multivariate analysis in the test cohort, preoperative parameters associated with MVI included α-fetoprotein (AFP; odds ratio [OR] 1.50, 95% confidence interval [CI] 1.23-1.83), imaging tumor burden score (TBS; hazard ratio [HR] 1.11, 95% CI 1.04-1.18), and neutrophil-to-lymphocyte ratio (NLR; OR 1.18, 95% CI 1.03-1.35). An online calculator to predict MVI was developed based on the weighted β-coefficients of these three variables ( https://yutaka-endo.shinyapps.io/MVIrisk/ ). The c-index of the test and validation cohorts was 0.71 and 0.72, respectively. Patients with a high risk of MVI had worse disease-free survival (DFS) and overall survival (OS) compared with low-risk MVI patients (3-year DFS: 33.0% vs. 51.9%, p < 0.001; 5-year OS: 44.2% vs. 64.8%, p < 0.001). DFS was worse among patients who underwent an R1 versus R0 resection among those patients at high risk of MVI (R0 vs. R1 resection: 3-year DFS, 36.3% vs. 16.1%, p = 0.002). In contrast, DFS was comparable among patients at low risk of MVI regardless of margin status (R0 vs. R1 resection: 3-year DFS, 52.9% vs. 47.3%, p = 0.16). Conclusion: Preoperative assessment of MVI using the online tool demonstrated very good accuracy to predict MVI.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol . 2023 Feb;30(2):725-733.pt_PT
dc.identifier.doi10.1245/s10434-022-12494-0pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4963
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectHumanspt_PT
dc.subjectCarcinoma, Hepatocellular* / pathologypt_PT
dc.subjectHepatectomypt_PT
dc.subjectLiver Neoplasms* / pathologypt_PT
dc.subjectNeoplasm Invasivenesspt_PT
dc.subjectRetrospective Studiespt_PT
dc.titleA Novel Online Calculator to Predict Risk of Microvascular Invasion in the Preoperative Setting for Hepatocellular Carcinoma Patients Undergoing Curative-Intent Surgerypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage733pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage725pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume30pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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