Nomogram for predicting the risk of extrahepatic metastasis in BCLC 0-A stage hepatocellular carcinoma patients after R0 hepatectomy

Chen Yao, Zhang Wanguang, Chen Xiaoping, Chen Yifa

Journal of Abdominal Surgery ›› 2022, Vol. 35 ›› Issue (1) : 25-30.

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Journal of Abdominal Surgery ›› 2022, Vol. 35 ›› Issue (1) : 25-30. DOI: 10.3969/j.issn.1003-5591.2022.01.005

Nomogram for predicting the risk of extrahepatic metastasis in BCLC 0-A stage hepatocellular carcinoma patients after R0 hepatectomy

  • Chen Yao, Zhang Wanguang, Chen Xiaoping, Chen Yifa
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Abstract

Objective To explore the risk factors of extrahepatic metastasis in Barcelona clinic liver cancer (BCLC) 0-A stage hepatocellular carcinoma (HCC) patients after R0 hepatectomy and construct a nomogram for predicting the risk of extrahepatic metastasis. Methods From January 1, 2014 and December 31, 2016, clinical data were collected from 351 hospitalized HCC patients fulfilling the inclusion criteria. And they were divided into extrahepatic and non-extrahepatic metastasis groups based upon whether or not the site of initial recurrence contained an extrahepatic organ. Based upon preoperative clinical data, model and nomogram for predicting the risk of extrahepatic metastasis were developed and their predictive performances evaluated. Finally clinical decision curve was utilized for evaluating the clinical application value of risk prediction model. Results There were extrahepatic metastasis group (n=36, 10.3%) and non-extrahepatic metastasis group (n=315, 89.7%). By Logistic regression, the independent risk factors for extrahepatic metastasis were identified, including alpha fetoprotein (AFP) grade[odds ratio (OR)=1.580, 95% confidence intervals (CI):1.182,2.144,P=0.002], tumor diameter (OR=1.103, 95%CI:1.002,1.209,P=0.039) and tumor necrosis (definite)(OR=2.379, 95%CI:1.042,5.222,P=0.034). And the model had an excellent predictive capability:area under receiver operating characteristic curve (AUC) was 0.740 with 95%CI 0.663-0.816 and Hosmer-Lemeshow(H-L) test p value 0.653. Finally clinical decision curve indicated that the model had decent clinical application value as well. Conclusion The independent risk factors for extrahepatic metastasis in BCLC 0-A stage HCC patients after R0 hepatectomy include AFP grade, tumor diameter and tumor necrosis. And the nomogram of extrahepatic metastatic risk shows an excellent capability of identifying high-risk patients.

Key words

Hepatocellular carcinoma / Hepatectomy / Metastasis / Nomogram

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Chen Yao, Zhang Wanguang, Chen Xiaoping, Chen Yifa. Nomogram for predicting the risk of extrahepatic metastasis in BCLC 0-A stage hepatocellular carcinoma patients after R0 hepatectomy[J]. Journal of Abdominal Surgery, 2022, 35(1): 25-30 https://doi.org/10.3969/j.issn.1003-5591.2022.01.005

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