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Related Experiment Video

Updated: Jun 28, 2025

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Assessing recent recurrence after hepatectomy for hepatitis B-related hepatocellular carcinoma by a predictive model

Hong Peng1, Si-Yi Lei1, Wei Fan2

  • 1Department of Infectious Diseases, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China.

World Journal of Gastroenterology
|April 15, 2024
PubMed
Summary

Sarcopenia, a condition of muscle loss, is linked to earlier recurrence of liver cancer (hepatocellular carcinoma) after surgery. A new model incorporating sarcopenia helps predict recurrence risk in patients with hepatitis B-related liver cancer.

Keywords:
Alpha-fetoproteinHepatectomyHepatitis B virusHepatocellular carcinomaNomogramPredictive modelsRecurrenceRecurrence-free survivalRisk factorsSarcopenia

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Area of Science:

  • Hepatobiliary surgery
  • Oncology
  • Nutritional science

Background:

  • Sarcopenia is a potential factor in hepatocellular carcinoma (HCC) recurrence post-hepatectomy.
  • Existing prediction models are insufficient for identifying early HCC recurrence (within 2 years).
  • There is a need for effective prediction models for early recurrence after HCC hepatectomy.

Purpose of the Study:

  • To develop an actionable prediction model for recurrence-free survival (RFS) after HCC hepatectomy.
  • To investigate the role of sarcopenia in predicting HCC recurrence.
  • To establish a model based on sarcopenia for predicting RFS in HCC patients.

Main Methods:

  • Retrospective analysis of 283 patients undergoing curative hepatectomy for hepatitis B-related HCC.
  • Preoperative CT scans used to measure skeletal muscle index at the third lumbar spine.
  • Cox multivariate analysis and nomogram development for RFS prediction, validated externally.

Main Results:

  • Sarcopenia, elevated alpha-fetoprotein, large tumor diameter (>5 cm), and high HBV DNA levels are independent risk factors for HCC recurrence.
  • The Sarcopenia to Assess Malignancy Disease (SAMD) model demonstrated good predictive performance (AUC 0.782 training, 0.773 validation).
  • A SAMD score ≥ 110 effectively identifies patients at high risk for postoperative HCC recurrence.

Conclusions:

  • Sarcopenia is significantly associated with early recurrence of hepatitis B-related HCC after hepatectomy.
  • The novel SAMD model, incorporating nutritional status (sarcopenia), offers superior prediction for postoperative HCC recurrence compared to existing models.
  • This nutritional status-based model aids in the prognostic prediction for patients with hepatitis B-related HCC.