P53 status combined with MRI findings for prognosis prediction of single hepatocellular carcinoma.

Abstract

Object: To develop and validate a nomogram for predicting recurrence in individuals suffering single hepatocellular carcinoma (HCC) after curative hepatectomy.

Material and methods: A retrospective analysis was conducted on 189 patients with single HCC undergoing curative resection in our center were randomized into training and validation cohorts. P53 status was determined using immunohistochemistry. Clinical data, such as age, and gender were collected. MRI findings, such as tumor size, intratumoral arteries, the presence of peritumoral enhancement and intratumoral necrosis were also recorded. Nomograms were established based on the predictors selected in the training cohort, and receiver operating characteristic (ROC) curve analyses were used to compare the predictive ability among single predictors and nomogram model. The Kaplan-Meier method was used to assess the impact of each predictor and nomogram model on HCC recurrence. The results were validated in the validation cohort.

Results: Multivariate Cox regression analysis showed that P53 (P < 0.001), tumor size (P = 0.009), and intratumoral artery (P = 0.026) were the independent risk factors for HCC recurrence. The nomogram model demonstrated favorable C-index of 0.740 (95 %CI:0.653-0.826) and 0.767 (95 %CI: 0.633-0.900) in the training and validation cohorts, and the areas under the curve was 0.740 and 0.752, which was better than the performance of P53 and MR factors alone. Calibration curves indicated a good agreement between observed actual outcomes and predicted values. Kaplan-Meier curves indicated that nomogram model was powerful in discrimination and clinical usefulness.

Conclusions: The integrated nomogram combining P53 status and MRI findings can be a valuable prognostic tool for predicting postoperative recurrence of single HCC.