A simple model to predict early recurrence of hepatocellular carcinoma after liver resection.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-08-23 DOI:10.1007/s00423-024-03449-y

Yi-Hao Yen, Yueh-Wei Liu, Wei-Feng Li, Chee-Chien Yong, Chih-Chi Wang, Chih-Yun Lin

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Abstract

Purpose: Multiple studies have reported models for predicting early recurrence of hepatocellular carcinoma (HCC) after liver resection (LR). However, these models are too complex to use in daily practice. We aimed to develop a simple model.

Method: We enrolled 1133 patients with newly diagnosed HCC undergoing LR. The Kaplan - Meier method and log-rank test were used for survival analysis and Cox proportional hazards analysis to identify prognostic factors associated with early recurrence (i.e., recurrence within two years after LR).

Results: Early recurrence was identified in 403 (35.1%) patients. In multivariate analysis, alpha-fetoprotein (AFP) 20-399 vs. < 20 ng/ml (HR = 1.282 [95% confidence interval = 1.002-1.639]; p = 0.048); AFP ≥ 400 vs. < 20 ng/ml (HR = 1.755 [1.382-2.229]; p < 0.001); 7th edition American Joint Committee on Cancer (AJCC) stage 2 vs. 1 (HR = 1.958 [1.505-2.547]; p < 0.001); AJCC stage 3 vs. 1 (HR = 4.099 [3.043-5.520]; p < 0.001); and pathology-defined cirrhosis (HR = 1.46 [1.200-1.775]; p < 0.001) were associated with early recurrence. We constructed a predictive model with these variables, which provided three risk strata for recurrence-free survival (RFS): low risk, intermediate risk, and high risk, with two-year RFS of 79%, 57%, and 35%, respectively (p < 0.001).

Conclusion: We developed a simple model to predict early recurrence risk for patients undergoing LR for HCC.

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预测肝切除术后肝细胞癌早期复发的简单模型

目的：多项研究报告了肝切除术（LR）后肝细胞癌（HCC）早期复发的预测模型。然而，这些模型过于复杂，难以在日常实践中使用。我们的目标是建立一个简单的模型：我们招募了 1133 名接受肝切除术的新诊断 HCC 患者。采用卡普兰-梅耶尔法和对数秩检验进行生存分析，并采用 Cox 比例危险度分析确定与早期复发（即 LR 后两年内复发）相关的预后因素：结果：403 例（35.1%）患者发现早期复发。在多变量分析中，甲胎蛋白（AFP）20-399 vs. 甲胎蛋白（AFP）20-399 vs. 甲胎蛋白（AFP）20-399 vs. 甲胎蛋白（AFP）20-399：我们建立了一个简单的模型来预测接受 LR 治疗的 HCC 患者的早期复发风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.