Validation of risk factors affecting the early recurrence of single lesion hepatocellular carcinoma with HBV related liver cirrhosis patients after curative resection

Background: Early recurrence is associated with poor prognosis after curative resection for hepatocellular carcinoma. Thus, we studied which factors, including this inflammation-based scoring system, affect disease recurrence in single hepatocellular carcinoma patients with liver cirrhosis. Methods: A total of 430 consecutive hepatocellular carcinoma patients were enrolled in our institution between January 2002 and December 2015. Survival rate, univariate, and multivariate analyses were performed to identify the variables associated with recurrence and early recurrence especially. Results: The overall survival rate was significantly lower in the early recurrence group than in the non-early recurrence group ( P<0.001). According to the multivariate analysis, protein induced by vitamin K absence or antagonist (PIVKA) greater than 200 ( P=0.035), neutrophil-to-lymphocyte ratio greater than 2.0 ( P<0.001), elevated Glasgow prognostic score ( P=0.003), tumor size greater than 5 cm ( P=0.002), and the presence of lymphovascular invasion ( P=0.002) were significantly different among the groups and affected the early recurrence of hepatocellular carcinoma. The patients were categorized into five levels of risk for early recurrence according to the number of independent risk factors, and patients with no risk factors were set as the reference group. Conclusion: Neutrophil-to-lymphocyte ratio, Glasgow prognostic score, and serum level of PIVKA offer significant prognostic information associated with early recurrence following single lesion hepatocellular carcinoma patients with liver cirrhosis after curative resection.

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Risk Factors for Early Recurrence of HBV-related Hepatocellular Carcinoma Meeting Milan Criteria after Curative Resection

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2013.14.12.7101 ◽

2013 ◽

Vol 14 (12) ◽

pp. 7101-7106 ◽

Cited By ~ 22

Author(s):

Wen-Jiang Zhu ◽

Chu-Ying Huang ◽

Chuan Li ◽

Wei Peng ◽

Tian-Fu Wen ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Curative Resection ◽

Early Recurrence ◽

Milan Criteria

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Predictive Value of Contrast-enhanced Ultrasound for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

Ultrasonic Imaging ◽

10.1177/0161734618815231 ◽

2018 ◽

Vol 41 (1) ◽

pp. 49-58 ◽

Cited By ~ 1

Author(s):

Qin Xiachuan ◽

Zhou xiang ◽

Liu xuebing ◽

Luo yan

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Early Recurrence ◽

Maximum Diameter ◽

Washout Rate ◽

Feeding Artery ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

The Us ◽

Single Lesion

This retrospective study aimed to use preoperative and contrast-enhanced ultrasound (CEUS) factors to assess and reveal risk factors of early recurrence (ER) in patients with hepatocellular carcinoma (HCC). We enrolled 141 patients with primary HCC who had undergone surgical resection. The assessment of the CEUS scan includes (a) the maximum diameter of the lesion, (b) the tumor echogenicity of gray-scale ultrasound (US), (c) the morphology of the tumor, (d) the margin of the tumor, (e) the peripheral hypoechoic halo, (f) tumor necrosis, (g) nutritional arteries shown by tumors, (h) ultrasonography for diagnosis of cirrhosis, and (i) the timer on the US screen displayed the time elapsed from the saline flush and was used to determine time to washout. According to the degree of the phase, the washout rate is divided into four grades, namely, levels 1 to 4. ER is defined as the time between resection and recurrence within 12 months after surgery. Risk factors for ER HCC were analyzed. Predictors of ER on a univariate logistic regression analysis in CEUS are size, washout rate, morphology, center necrosis, and feeding artery appearing in the tumor. Multivariate analysis results indicated that feeding artery, microvascular invasion (MVI), and washout rate were independent risk factors for ER. The relative high risk of ER for washout rate 1, 2, 3, and 4 were 29.3%, 43.2%, 53.1%, and 71.4%, respectively. The appropriateness of hepatectomy in the treatment of single lesion HCC should be carefully considered when the washout rate was 4.

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Hyperglycemia-Associated Early Hepatocellular Carcinoma Recurrence After Open Radical Hepatectomy

10.21203/rs.3.rs-127798/v1 ◽

2020 ◽

Author(s):

Peng Liu ◽

Yixiu Wang ◽

Yuwei Xie ◽

Luxun Zhang ◽

Jinyu Pei ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Blood Glucose ◽

Survival Rate ◽

Adjuvant Treatment ◽

Radical Resection ◽

Early Recurrence ◽

Free Survival ◽

Factors Affecting ◽

Postoperative Adjuvant Treatment

Abstract BackgroundWe investigated the impact of elevated glucose levels on the early recurrence of hepatocellular carcinoma (HCC)after open radical hepatectomy.MethodsThis retrospective cohort study analyzed. The clinical data of 112 patients with hepatocellular carcinoma who underwent open radical hepatectomy from January 2013 to December 2014 at the Affiliated Hospital of Qingdao University. After radical resection of the hepatocellular carcinoma, 86 patients with an average fasting blood glucose(FBG) level of 3.9–6.1 mmol/L and 26 patients with an FBG level ≥ 6.1 mmol/L were divided into the normal group and hyperglycemic group, respectively. The recurrence rate of hepatocellular carcinoma was compared between the two groups 1 and 2 years after the operation.ResultsThe postoperative 1- and 2-year recurrence rates of HCC were 19.8% (17/86) and 33.7% (29/86), respectively, in the normal group and42.3% (11/26) and 61.5% (16/26), respectively, in the hyperglycemic group; there were significant differences between the two groups (χ2 = 6.719,P = 0.01;χ2 = 6.427༌P = 0.011). The univariate analysis showed that FBG, history of alcohol drinking, extent of hepatectomy, histopathological differentiation, maximal tumor diameter, satellite lesion, and the postoperative adjuvant treatment were risk factors affecting the tumor-free survival rate after open radical resection of hepatocellular carcinoma (P < .05).The results of the multivariate analysis showed that FBG levels ≥ 6.1 mmol/L, low histopathological differentiation, and no postoperative adjuvant treatment were independent risk factors affecting tumor-free survival rate after radical resection of hepatocellular carcinoma (P < .05).ConclusionAn elevated FBG level has a stimulating effect on the early recurrence of tumor after open radical resection of hepatocellular carcinoma. Therefore, postoperative monitoring and blood glucose control may facilitate a decrease in the early recurrence rate in patients with hepatocellular carcinoma.

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A Deep Learning Nomogram for the Prediction of Early Recurrence in Hepatocellular Carcinoma After Curative Surgery

10.21203/rs.3.rs-1163321/v1 ◽

2021 ◽

Author(s):

Meng Yan ◽

Xiao Zhang ◽

Bin Zhang ◽

Zhijun Geng ◽

Chuanmiao Xie ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Deep Learning ◽

Curative Resection ◽

Early Recurrence ◽

Clinical Risk Factors ◽

Arterial Phase ◽

Hepatobiliary Phase ◽

Clinical Risk ◽

Independent Risk Factors

Abstract Purpose: The accurate prediction of post-hepatectomy early recurrence in patients with hepatocellular carcinoma (HCC) is crucial for decision-making regarding postoperative adjuvant treatment and monitoring. We aimed to develop and validate a deep-learning (DL) nomogram based on MRI for predicting early recurrence in HCC after curative resection. Methods: We retrospectively included 285 HCC patients who underwent Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI within one month before curative resection. Deep features were extracted from images of the arterial phase (AP), portal venous phase (PVP), and hepatobiliary phase (HBP) using VGGNet-19. Pearson’s correlation was firstly used to exclude redundant features. Three feature selection methods and five classification methods were combined to construct the DL signature. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for the early recurrence, which were incorporated into the DL nomogram. Results: Microvascular invasion (P = 0.039), tumor number (P = 0.001), and three-phase-based DL signature (P<0.0001) were independent risk factors for early recurrence. The DL nomogram integrating the DL signature and clinical risk factors outperformed the clinical nomogram which combined clinical risk factors, in the training set (AUC: 0.949 vs. 0.751; P<0.0001) and validation set (AUC: 0.908 vs. 0.712; P = 0.002). Excellent calibration was achieved for the DL nomogram in both training and validation sets. Decision curve analysis confirmed the clinical usefulness of the DL nomogram. Conclusions: The proposed DL nomogram was superior to the traditional clinical nomogram in predicting early recurrence for HCC patients after curative resection.

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Early recurrence after radiofrequency ablation for hepatocellular carcinoma: a multicenter retrospective study on definition, patterns and risk factors

International Journal of Hyperthermia ◽

10.1080/02656736.2020.1849828 ◽

2021 ◽

Vol 38 (1) ◽

pp. 437-446

Author(s):

Yi Yang ◽

Yujing Xin ◽

Feng Ye ◽

Ning Liu ◽

Xinyuan Zhang ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Retrospective Study ◽

Radiofrequency Ablation ◽

Early Recurrence

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Inflammatory indexes in preoperative blood routine to predict early recurrence of hepatocellular carcinoma after curative hepatectomy

BMC Surgery ◽

10.1186/s12893-021-01180-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

YiFeng Wu ◽

ChaoYong Tu ◽

ChuXiao Shao

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Tumour Size ◽

Area Under The Curve ◽

Early Recurrence ◽

Recurrence Free Survival ◽

Free Survival ◽

Lymphocyte Ratio ◽

Inflammatory Index ◽

Curative Hepatectomy

Abstract Background The inflammation indexes in blood routine play an essential role in evaluating the prognosis of patients with hepatocellular carcinoma, but the effect on early recurrence has not been clarified. The study aimed to investigate the risk factors of early recurrence (within 2 years) and recurrence-free survival after curative hepatectomy and explore the role of inflammatory indexes in predicting early recurrence. Methods The baseline data of 161 patients with hepatocellular carcinoma were analyzed retrospectively. The optimal cut-off value of the inflammatory index was determined according to the Youden index. Its predictive performance was compared by the area under the receiver operating characteristic curve. Logistic and Cox regression analyses were used to determine the risk factors of early recurrence and recurrence-free survival. Results The area under the curve of monocyte to lymphocyte ratio (MLR) for predicting early recurrence was 0.700, which was better than systemic inflammatory response index (SIRI), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immune-inflammatory index (SII). MLR, tumour size, tumour differentiation and BCLC stage are all risk factors for early recurrence and recurrence-free survival of HCC. Combining the above four risk factors to construct a joint index, the area under the curve for predicting early recurrence was 0.829, which was better than single MLR, tumour size, tumour differentiation and BCLC stage. Furthermore, with the increase of risk factors, the recurrence-free survival of patients is worse. Conclusion The combination of MLR and clinical risk factors is helpful for clinicians to identify high-risk patients with early recurrence and carry out active postoperative adjuvant therapy to improve the prognosis of patients.

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A long non-coding RNA-based signature predicts early recurrence in hepatocellular carcinoma

Cancer Biomarkers ◽

10.3233/cbm-210193 ◽

2021 ◽

pp. 1-10

Author(s):

Shuai He ◽

Jin-Feng Li ◽

Hao Tian ◽

Ye Sang ◽

Xiao-Jing Yang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Curative Resection ◽

Risk Model ◽

Cox Regression ◽

Early Recurrence ◽

Support Vector ◽

Term Survival ◽

Cox Regression Analysis ◽

Non Coding Rna ◽

Long Non Coding Rna

BACKGROUND: Early recurrence is the main obstacle for long-term survival of hepatocellular carcinoma (HCC) patients after curative resection. OBJECTIVE: We aimed to develop a long non-coding RNA (lncRNA) based signature to predict early recurrence. METHODS: Using bioinformatics analysis and quantitative reverse transcription PCR (RT-qPCR), we screened for lncRNA candidates that were abnormally expressed in HCC. The expression levels of candidate lncRNAs were analyzed in HCC tissues from 160 patients who underwent curative resection, and a risk model for the prediction of recurrence within 1 year (early recurrence) of HCCs was constructed with linear support vector machine (SVM). RESULTS: A lncRNA-based classifier (Clnc), which contained nine differentially expressed lncRNAs including AF339810, AK026286, BC020899, HEIH, HULC, MALAT1, PVT1, uc003fpg, and ZFAS1 was constructed. In the test set, this classifier reliably predicted early recurrence (AUC, 0.675; sensitivity, 72.0%; specificity, 63.1%) with an odds ratio of 4.390 (95% CI, 2.120–9.090). Clnc showed higher accuracy than traditional clinical features, including tumor size, portal vein tumor thrombus (PVTT) in predicting early recurrence (AUC, 0.675 vs 0.523 vs 0.541), and had much higher sensitivity than Barcelona Clinical Liver Cancer (BCLC; 72.0% vs 50.0%), albeit their AUCs were comparable (0.675 vs 0.678). Moreover, combining Clnc with BCLC significantly increased the AUC, compared with Clnc or BCLC alone in predicting early recurrence (all P< 0.05). Finally, logistic and Cox regression analysis suggested that Clnc was an independent prognostic factor and associated with the early recurrence and recurrence-free survival of HCC patients after resection, respectively (all P= 0.001). CONCLUSIONS: Our lncRNA-based classifier Clnc can predict early recurrence of patients undergoing surgical resection of HCC.

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