A Clinical-Imaging Nomogram for Predicting Post-Hepatectomy Recurrence in Hepatocellular Carcinoma with Microvascular
Shiyuan Huang1, Bin Chen2, Yunyun Wei3
1Hospital Administrative Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Summary
This study developed a nomogram to predict recurrence in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) after surgery. The tool aids in risk stratification and personalized treatment planning for better patient outcomes.
Area of Science:
- Hepatobiliary Surgery
- Oncology
- Medical Imaging
Background:
- Hepatocellular carcinoma (HCC) recurrence post-hepatectomy remains a challenge, particularly in patients with microvascular invasion (MVI).
- Accurate prediction of recurrence is crucial for effective postoperative management and adjuvant therapy selection.
Purpose of the Study:
- To develop and validate an individualized nomogram for predicting recurrence-free survival (RFS) in MVI-positive HCC patients after hepatectomy.
- To integrate clinical and imaging features for enhanced predictive accuracy.
Main Methods:
- Retrospective analysis of 317 MVI-positive HCC patients who underwent curative resection.
- Identification of independent risk factors for RFS using Cox regression analysis.
- Nomogram construction and performance evaluation using C-index, ROC curves, calibration curves, and DCA.
Main Results:
- A nomogram incorporating MVI grade, AFP, liver cirrhosis, and smooth tumor margin was developed.
- The nomogram demonstrated good discriminative ability (C-index 0.758 training, 0.702 validation) and calibration.
- High-risk patients identified by the nomogram had significantly worse RFS, and DCA confirmed clinical utility.
Conclusions:
- The developed clinical-imaging nomogram effectively predicts post-hepatectomy recurrence in MVI-positive HCC patients.
- This tool enables individualized risk stratification, guiding postoperative surveillance and adjuvant therapy decisions.
- It assists in identifying high-risk patients for timely and targeted interventions.
