Independent Risk Factors of Early Recurrence After Curative Resection for Perihilar Cholangiocarcinoma: Adjuvant Chemotherapy May Be Beneficial in Early Recurrence Subgroup

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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Risk Factors Associated With Early Recurrence of Borderline Resectable Pancreatic Ductal Adenocarcinoma After Neoadjuvant Chemoradiation Therapy and Curative Resection

Anticancer Research ◽

10.21873/anticanres.13615 ◽

2019 ◽

Vol 39 (8) ◽

pp. 4431-4440 ◽

Cited By ~ 1

Author(s):

NOBUHIRO TSUCHIYA ◽

RYUSEI MATSUYAMA ◽

TAKASHI MURAKAMI ◽

YASUHIRO YABUSHITA ◽

YU SAWADA ◽

...

Keyword(s):

Risk Factors ◽

Pancreatic Ductal Adenocarcinoma ◽

Curative Resection ◽

Early Recurrence ◽

Neoadjuvant Chemoradiation ◽

Chemoradiation Therapy ◽

Ductal Adenocarcinoma ◽

Borderline Resectable ◽

Factors Associated ◽

Neoadjuvant Chemoradiation Therapy

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Risk Factors for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

World Journal of Surgery ◽

10.1007/s00268-016-3529-7 ◽

2016 ◽

Vol 40 (10) ◽

pp. 2466-2471 ◽

Cited By ~ 17

Author(s):

Mitsugi Shimoda ◽

Kazuma Tago ◽

Takayuki Shiraki ◽

Shozo Mori ◽

Masato Kato ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Curative Resection ◽

Early Recurrence ◽

Single Lesion

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Tumor Stage-Based Gross Tumor Volume of Resectable Esophageal Squamous Cell Carcinoma Measured on CT: Association With Early Recurrence After Esophagectomy

Frontiers in Oncology ◽

10.3389/fonc.2021.753797 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yu-ping Wu ◽

Sun Tang ◽

Bang-guo Tan ◽

Li-qin Yang ◽

Fu-lin Lu ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Esophageal Squamous Cell Carcinoma ◽

Predictive Models ◽

Gross Tumor Volume ◽

Roc Analysis ◽

Tumor Volume ◽

Tumor Stage ◽

Early Recurrence ◽

Independent Risk Factors

ObjectiveTo investigate relationship of tumor stage-based gross tumor volume (GTV) of esophageal squamous cell carcinoma (ESCC) measured on computed tomography (CT) with early recurrence (ER) after esophagectomy.Materials and MethodsTwo hundred and four consecutive patients with resectable ESCC including 159 patients enrolled in the training cohort (TC) and 45 patients in validation cohort (VC) underwent contrast-enhanced CT less than 2 weeks before esophagectomy. GTV was retrospectively measured by multiplying sums of all tumor areas by section thickness. For the TC, univariate and multivariate analyses were performed to determine factors associated with ER. Mann-Whitney U test was conducted to compare GTV in patients with and without ER. Receiver operating characteristic (ROC) analysis was performed to determine if tumor stage-based GTV could predict ER. For the VC, unweighted Cohen’s Kappa tests were used to evaluate the performances of the previous ROC predictive models.ResultsER occurred in 63 of 159 patients (39.6%) in the TC. According to the univariate analysis, histologic differentiation, cT stage, cN stage, and GTV were associated with ER after esophagectomy (all P-values < 0.05). Multivariate analysis revealed that cT stage and GTV were independent risk factors with hazard ratios of 3.382 [95% confidence interval (CI): 1.533–7.459] and 1.222 (95% CI: 1.125–1.327), respectively (all P-values < 0.05). Mann-Whitney U tests showed that GTV could help differentiate between ESCC with and without ER in stages cT1-4a, cT2, and cT3 (all P-values < 0.001), and the ROC analysis demonstrated the corresponding cutoffs of 13.31, 17.22, and 17.83 cm3 with areas under the curve of more than 0.8, respectively. In the VC, the Kappa tests validated that the ROC predictive models had good performances for differentiating between ESCC with and without ER in stages cT1-4a, cT2, and cT3 with Cohen k of 0.696 (95% CI, 0.498–0.894), 0.733 (95% CI, 0.386–1.080), and 0.862 (95% CI, 0.603–1.121), respectively.ConclusionGTV and cT stage can be independent risk factors of ER in ESCC after esophagectomy, and tumor stage-based GTV measured on CT can help predict ER.

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Inflammation-based Indexes Upon Adjuvant Chemotherapy Initiation as a Predictor of Relapse After Curative Resection of Colorectal Cancer With an Oxaliplatin-based Regimen

Cancer Diagnosis & Prognosis ◽

10.21873/cdp.10077 ◽

2022 ◽

Vol 2 (1) ◽

pp. 64-70

Author(s):

MASAYA SATAKE ◽

KAZUHIKO YOSHIMATSU ◽

MASANO SAGAWA ◽

HAIJIME YOKOMIZO ◽

SHUNICHI SHIOZAWA

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Adjuvant Chemotherapy ◽

Curative Resection ◽

Prognostic Score ◽

Univariate Analysis ◽

Significant Risk ◽

Stage Ii ◽

Lymphocyte Ratio ◽

Chemotherapy Initiation

Background/Aim: We investigated the clinical efficacy of inflammation-based indexes in predicting unfavourable relapse-free survival (RFS) in patients with stage II/III colorectal cancer (CRC) receiving oxaliplatin-based adjuvant chemotherapy. Patients and Methods: A retrospective analysis was performed on 45 patients who underwent curative resection for stage II/III CRC followed by oxaliplatin-based adjuvant chemotherapy after 8 weeks. Upon adjuvant chemotherapy initiation, all patients were evaluated for lymphocyte count (LC), neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS) and prognostic nutritional index (PNI), after which their correlation with relapse was analysed. Results: Univariate analysis identified LC <1,350/mm3, NLR ≥2.03, LMR <5.15, PLR ≥209, mGPS 2, and early discontinuation of chemotherapy within two months as significant risk factors for RFS. Multivariate analysis identified LMR <5.15, PLR > 209 and mGPS 2 as significant independent risk factors for unfavourable RFS. Conclusion: Measurement of LMR, PLR, and mGPS upon adjuvant therapy initiation can be a useful tool for predicting recurrence after curative surgery for stage II/III CRC.

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Prognostic markers affecting the early recurrence of hepatocellular carcinoma with liver cirrhosis after curative resection

The International Journal of Biological Markers ◽

10.1177/1724600819834306 ◽

2019 ◽

Vol 34 (2) ◽

pp. 123-131 ◽

Cited By ~ 3

Author(s):

Wan-Joon Kim ◽

Tae-Wan Lim ◽

Pyoung-Jae Park ◽

Sae-Byeol Choi ◽

Wan-Bae Kim

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Survival Rate ◽

Curative Resection ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Early Recurrence ◽

Lymphocyte Ratio ◽

Recurrence Group

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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TERT Mutations Correlated With the Prognosis of Patients With Hepatitis B-Related Hepatocellular Carcinoma Underwent Curative Hepatectomy

10.21203/rs.3.rs-283746/v1 ◽

2021 ◽

Author(s):

Kangjian Song ◽

Junyu Huo ◽

Fu He ◽

Qingwei Zhu ◽

Liqun Wu

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Hepatitis B ◽

Poor Prognosis ◽

Early Recurrence ◽

Single Factor ◽

Risk Factors For Recurrence ◽

Independent Risk Factors ◽

Curative Hepatectomy

Abstract Background To explore the value of TERT mutations in predicting the early recurrence and prognosis of hepatitis B-related hepatocellular carcinoma (HCC) patients underwent curative hepatectomy.Methods A total of 81 patients with hepatitis B-related HCC were enrolled and all patients underwent curative hepatectomy. Associations were sought between TERT mutations and recurrence rate within 2 years after hepatectomy, time to progress (TTP) and overall survival (OS).Results TERT mutations (HR: 2.985, 95%CI: 1.158-7.692, p=0.024) and Barcelona clinic liver (BCLC) stage B (HR: 3.326, 95%CI: 1.019-10.856, p=0.046) were independent risk factors for recurrence within 2 years after hepatectomy. Patients with a TERT mutation had poor TTP (p=0.003) and OS (p=0.013) than others. TERT mutations (HR: 2.245, 95%CI: 1.185-4.252, p=0.013) and BCLC stage B (HR: 2.132, 95%CI: 1.082-4.198, p=0.029) were independent risk factors for poor TTP after curative hepatectomy. A predictive model based on TERT mutations and BCLC stage had better ability to predict early recurrence after hepatectomy of HCC patients than any single factor (AUC: 0.688 vs. 0.639, 0.688 vs. 0.607, respectively). Patients with both TERT mutations and BCLC stage B had poorer TTP and OS than others (p=0.001, p<0.001, respectively).Conclusion TERT mutations had ability to predict early recurrence and poor prognosis for hepatitis B-related HCC patients underwent curative hepatectomy.

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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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Prognostic value and predication model of microvascular invasion in patients with intrahepatic cholangiocarcinoma: a multicenter study from China

BMC Cancer ◽

10.1186/s12885-021-09035-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yifan Chen ◽

Hongzhi Liu ◽

Jinyu Zhang ◽

Yijun Wu ◽

Weiping Zhou ◽

...

Keyword(s):

Risk Factors ◽

Prediction Model ◽

Intrahepatic Cholangiocarcinoma ◽

Curative Resection ◽

Survival Curves ◽

Tumor Number ◽

Good Consistency ◽

Before And After ◽

Preoperative Image ◽

Independent Risk Factors

Abstract Background At present, hepatectomy is still the most common and effective treatment method for intrahepatic cholangiocarcinoma (ICC) patients. However, the postoperative prognosis is poor. Therefore, the prognostic factors for these patients require further exploration. Whether microvascular invasion (MVI) plays a crucial role in the prognosis of ICC patients is still unclear. Moreover, few studies have focused on preoperative predictions of MVI in ICC patients. Methods Clinicopathological data of 704 ICC patients after curative resection were retrospectively collected from 13 hospitals. Independent risk factors were identified by the Cox or logistic proportional hazards model. In addition, the survival curves of the MVI-positive and MVI-negative groups before and after matching were analyzed. Subsequently, 341 patients from a single center (Eastern Hepatobiliary Hospital) in the above multicenter retrospective cohort were used to construct a nomogram prediction model. Then, the model was evaluated by the index of concordance (C-Index) and the calibration curve. Results After propensity score matching (PSM), Child-Pugh grade and MVI were independent risk factors for overall survival (OS) in ICC patients after curative resection. Major hepatectomy and MVI were independent risk factors for recurrence-free survival (RFS). The survival curves of OS and RFS before and after PSM in the MVI-positive groups were significantly different compared with those in the MVI-negative groups. Multivariate logistic regression results demonstrated that age, gamma-glutamyl transpeptidase (GGT), and preoperative image tumor number were independent risk factors for the occurrence of MVI. Furthermore, the prediction model in the form of a nomogram was constructed, which showed good prediction ability for both the training (C-index = 0.7622) and validation (C-index = 0.7591) groups, and the calibration curve showed good consistency with reality. Conclusion MVI is an independent risk factor for the prognosis of ICC patients after curative resection. Age, GGT, and preoperative image tumor number were independent risk factors for the occurrence of MVI in ICC patients. The prediction model constructed further showed good predictive ability in both the training and validation groups with good consistency with reality.

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Endoscopic and Histopathology Characteristics in Patients with Esophageal High-Grade Intraepithelial Neoplasia

Digestive Surgery ◽

10.1159/000490112 ◽

2018 ◽

Vol 36 (5) ◽

pp. 384-393 ◽

Cited By ~ 1

Author(s):

Huai-Ming Sang ◽

Jiu-Liang Cao ◽

Muhammad Djaleel Soyfoo ◽

Wei-Ming Zhang ◽

Jian-Xia Jiang ◽

...

Keyword(s):

Risk Factors ◽

Curative Resection ◽

Narrow Band Imaging ◽

Histological Grade ◽

Intraepithelial Neoplasia ◽

Lesion Size ◽

High Grade ◽

Independent Risk Factors ◽

Endoscopic Characteristics ◽

Endoscopic Forceps Biopsy

Background/Aims: To correlate the endoscopic characteristics with the histopathology of specimens of esophageal high-grade intraepithelial neoplasia obtained by endoscopic submucosal dissection (ESD). Methods: This was a retrospective study developed from January 2010 to December 2015. The study included 169 patients who underwent ESD and were diagnosed with esophageal high-grade intraepithelial neoplasia according to endoscopic forceps biopsy, Lugol staining, endoscopic ultrasonography, computed tomography, and Narrow-Band Imaging. The demographic, endoscopic, and histopathologic characteristics were analyzed. Results: A total of 19 cases (11.2%) had a change in diagnosis after histopathology exam and 16 (9.5%) needed a change in established treatment. An increase in the severity of disease was correlated with a lesion size > 2 cm, less than 4 samples in biopsy, and depressed or excavated patterns (p < 0.05). One hundred forty patients (82.8%) underwent curative resection. Lesions with leukoplakia (p < 0.001) and negative Lugol staining (p = 0.028) were independent risk factor for non-curative resection. Conclusion: This study confirms that lesion size > 2 cm, depressed and excavated patterns, and ≤4 biopsy samples are independent risk factors for histological grade changes compared to pre-endoscopic treatment diagnosis. Similarly, leukoplakia and no Lugol staining of lesions are independent risk factors for non-curative resection.

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