Estimating Microvascular Invasion in Patients with Resectable Multinodular Hepatocellular Carcinoma by Using...

Area of Science:

• Hepatobiliary surgery
• Oncology
• Radiology

Background:

• Multinodular hepatocellular carcinoma (mHCC) poses challenges in predicting outcomes.
• Microvascular invasion (MVI) is a critical factor influencing recurrence and survival in mHCC.
• Accurate preoperative prediction of MVI is essential for treatment planning.

Purpose of the Study:

• To identify preoperative clinicoradiological factors predicting MVI in resectable mHCC.
• To develop and validate a risk scoring system for MVI prediction.
• To stratify mHCC patients into risk subgroups based on the developed score.

Main Methods:

• Analysis of clinicoradiological data from 273 mHCC patients undergoing hepatectomy.
• Multivariable logistic regression to identify independent predictors of MVI.
• Development and validation of a risk score system using training and validation cohorts.
• Evaluation of the risk score's performance using C-index, calibration, and decision curve analysis.

Main Results:

• Elevated AFP (>400 ng/mL), satellite nodules, mosaic architecture, and increased total tumor diameter were independent predictors of MVI.
• Fat in mass was identified as a protective factor against MVI.
• The risk score demonstrated good predictive performance (C-index: 0.777 in training, 0.758 in validation).
• The risk score effectively stratified patients into high- and low-MVI-risk groups with significantly different recurrence-free survival.

Conclusions:

• A novel risk score incorporating clinicoradiological parameters accurately predicts MVI in resectable mHCC.
• The risk score facilitates stratification of mHCC patients into distinct prognostic subgroups.
• This tool aids in personalized treatment strategies and prognosis assessment for mHCC.