■目前缺乏预测增殖性肝细胞癌(HCC)的预测模型,子类型的集成类,以令人沮丧的预后为特征。因此,本研究旨在开发并验证一种新的预后模型,该模型能够准确预测根治性切除术后增殖性HCC的预后。
■这项回顾性多中心研究包括2014年8月至2020年12月接受根治性肝切除术的孤立性HCC患者(n=816)。根据组织学标准,将患者分为增殖性HCC队列(n=259)或非增殖性HCC队列(n=557)。比较两组患者在一对一倾向评分匹配(PSM)前后的无病生存率(DFS)。在所有增殖性肝癌患者中,203名患者被分配到训练队列,56例患者被分配到验证队列.在训练队列中进行单变量和多变量分析,以确定与不良DFS相关的危险因素。此后,建立了一个预测模型,随后在验证队列中验证。
■增殖性HCC在PSM前后的DFS明显低于非增殖性HCC。同时,多因素回归分析显示,肝硬化(P=0.032)、肿瘤体积较大(P=0.000)是DFS恶化的独立危险因素。最后,预测模型对1、3、5年DFS率的判别能力,由接受者工作特性(ROC)曲线确定,在训练队列中为0.702、0.720和0.809,在验证队列中为0.752、0.776和0.851,分别。
■这项研究开发了一种具有令人满意的准确性的预测模型,以预测肝切除术后增殖性HCC中DFS较差。此外,这种预测模型可以作为临床医生预测肝癌术后复发的有价值的工具,从而使他们能够实施早期预防策略。
UNASSIGNED: There is a scarcity of predictive models currently accessible for prognosticating proliferative hepatocellular carcinoma (HCC), an integrated class of subtype, characterized by a dismal prognosis. Consequently, this study aimed to develop and validate a novel prognostic model capable of accurately predicting the prognosis of proliferative HCC after curative resection.
UNASSIGNED: This retrospective multicenter study included patients with solitary HCC who underwent curative liver resection from August 2014 to December 2020 (n = 816). Patients were stratified into either the proliferative HCC cohort (n = 259) or the nonproliferative HCC cohort (n = 557) based on histological criteria. Disease-free survival (DFS) was compared between the two groups before and after one-to-one propensity score matching (PSM). Of all the proliferative HCC patients, 203 patients were assigned to training cohort, and 56 patients were assigned to validation cohort. Univariate and multivariate analyses were performed in training cohort to identify risk factors associated with worse DFS. Thereafter, a predictive model was constructed, subsequently validated in the validation cohort.
UNASSIGNED: The DFS of proliferative HCC was significantly worse than nonproliferative HCC before and after PSM. Meanwhile, multivariate regression analysis revealed that liver cirrhosis (P = 0.032) and larger tumor size (P = 0.000) were independent risk factors of worse DFS. Lastly, the discriminative abilities of the predictive model for 1, 3, 5-year DFS rates, as determined by receiver operating characteristic (ROC) curves, were 0.702, 0.720, and 0.809 in the training cohort and 0.752, 0.776, and 0.851 in the validation cohort, respectively.
UNASSIGNED: This study developed a predictive model with satisfactory accuracy to predict the worse DFS in proliferative HCCs after liver resection. Moreover, this predictive model may serve as a valuable tool for clinicians to predict postoperative HCC recurrence, thereby enabling them to implement early preventative strategies.