Estimating postsurgical outcomes of patients with a single hepatocellular carcinoma using gadoxetic acid–enhanced MRI: risk scoring system development and validation.
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| Title: | Estimating postsurgical outcomes of patients with a single hepatocellular carcinoma using gadoxetic acid–enhanced MRI: risk scoring system development and validation. |
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| Authors: | Park, So Hyun1, Kim, Bohyun2 kbh@catholic.ac.kr, Kim, Sehee3, Park, Suyoung1, Park, Yeon Ho4, Shin, Seung Kak5, Sung, Pil Soo6, Choi, Joon-Il2 |
| Source: | European Radiology. May2023, Vol. 33 Issue 5, p3566-3579. 14p. 1 Black and White Photograph, 1 Diagram, 4 Charts, 2 Graphs. |
| Subjects: | Disease risk factors, Tumor markers, Hepatocellular carcinoma, Alpha fetoproteins, Systems development, Proportional hazards models, Clinical prediction rules, Magnetic resonance imaging |
| Abstract: | Objectives: To develop and validate risk scoring systems using gadoxetic acid–enhanced liver MRI features and clinical factors that predict recurrence-free survival (RFS) of a single hepatocellular carcinoma (HCC). Methods: Consecutive 295 patients with treatment-naïve single HCC who underwent curative surgery were retrospectively enrolled from two centers. Cox proportional hazard models developed risk scoring systems whose discriminatory powers were validated using external data and compared to the Barcelona Clinic Liver Cancer (BCLC) or American Joint Committee on Cancer (AJCC) staging systems using Harrell's C-index. Results: Independent variables—tumor size (per cm; hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.02–1.13; p = 0.005), targetoid appearance (HR, 1.74; 95% CI: 1.07–2.83; p = 0.025), radiologic tumor in vein or tumor vascular invasion (HR, 2.59; 95% CI: 1.69–3.97; p < 0.001), the presence of a nonhypervascular hypointense nodule on the hepatobiliary phase (HR, 4.65; 95% CI: 3.03–7.14; p < 0.001), and pathologic macrovascular invasion (HR, 2.60; 95% CI: 1.51–4.48; p = 0.001)—with tumor markers (AFP ≥ 206 ng/mL or PIVKA-II ≥ 419 mAU/mL) derived pre- and postoperative risk scoring systems. The risk scores showed comparably good discriminatory powers in the validation set (C-index, 0.75–0.82) and outperformed the BCLC (C-index, 0.61) and AJCC staging systems (C-index, 0.58; ps < 0.05). The preoperative scoring system stratified the patients into low-, intermediate-, and high-risk for recurrence, whose 2-year recurrence rate was 3.3%, 31.8%, and 85.7%, respectively. Conclusion: The developed and validated pre- and postoperative risk scoring systems can estimate RFS after surgery for a single HCC. Key Points: • The risk scoring systems predicted RFS better than the BCLC and AJCC staging systems (C-index, 0.75–0.82 vs. 0.58–0.61; ps < 0.05). • Five variables—tumor size, targetoid appearance, radiologic tumor in vein or vascular invasion, the presence of a nonhypervascular hypointense nodule on the hepatobiliary phase, and pathologic macrovascular invasion—combined with tumor markers derived risk scoring systems predicting postsurgical RFS for a single HCC. • In the risk scoring system using preoperatively-available factors, patients were classified into three distinct risk groups, with 2-year recurrence rates in the low-, intermediate-, and high-risk groups being 3.3%, 31.8%, and 85.7% in the validation set. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Estimating postsurgical outcomes of patients with a single hepatocellular carcinoma using gadoxetic acid–enhanced MRI: risk scoring system development and validation. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Park%2C+So+Hyun%22">Park, So Hyun</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Kim%2C+Bohyun%22">Kim, Bohyun</searchLink><relatesTo>2</relatesTo><i> kbh@catholic.ac.kr</i><br /><searchLink fieldCode="AR" term="%22Kim%2C+Sehee%22">Kim, Sehee</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Park%2C+Suyoung%22">Park, Suyoung</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Park%2C+Yeon+Ho%22">Park, Yeon Ho</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Shin%2C+Seung+Kak%22">Shin, Seung Kak</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Sung%2C+Pil+Soo%22">Sung, Pil Soo</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Choi%2C+Joon-Il%22">Choi, Joon-Il</searchLink><relatesTo>2</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. May2023, Vol. 33 Issue 5, p3566-3579. 14p. 1 Black and White Photograph, 1 Diagram, 4 Charts, 2 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Tumor+markers%22">Tumor markers</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatocellular+carcinoma%22">Hepatocellular carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22Alpha+fetoproteins%22">Alpha fetoproteins</searchLink><br /><searchLink fieldCode="DE" term="%22Systems+development%22">Systems development</searchLink><br /><searchLink fieldCode="DE" term="%22Proportional+hazards+models%22">Proportional hazards models</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+prediction+rules%22">Clinical prediction rules</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: To develop and validate risk scoring systems using gadoxetic acid–enhanced liver MRI features and clinical factors that predict recurrence-free survival (RFS) of a single hepatocellular carcinoma (HCC). Methods: Consecutive 295 patients with treatment-naïve single HCC who underwent curative surgery were retrospectively enrolled from two centers. Cox proportional hazard models developed risk scoring systems whose discriminatory powers were validated using external data and compared to the Barcelona Clinic Liver Cancer (BCLC) or American Joint Committee on Cancer (AJCC) staging systems using Harrell's C-index. Results: Independent variables—tumor size (per cm; hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.02–1.13; p = 0.005), targetoid appearance (HR, 1.74; 95% CI: 1.07–2.83; p = 0.025), radiologic tumor in vein or tumor vascular invasion (HR, 2.59; 95% CI: 1.69–3.97; p < 0.001), the presence of a nonhypervascular hypointense nodule on the hepatobiliary phase (HR, 4.65; 95% CI: 3.03–7.14; p < 0.001), and pathologic macrovascular invasion (HR, 2.60; 95% CI: 1.51–4.48; p = 0.001)—with tumor markers (AFP ≥ 206 ng/mL or PIVKA-II ≥ 419 mAU/mL) derived pre- and postoperative risk scoring systems. The risk scores showed comparably good discriminatory powers in the validation set (C-index, 0.75–0.82) and outperformed the BCLC (C-index, 0.61) and AJCC staging systems (C-index, 0.58; ps < 0.05). The preoperative scoring system stratified the patients into low-, intermediate-, and high-risk for recurrence, whose 2-year recurrence rate was 3.3%, 31.8%, and 85.7%, respectively. Conclusion: The developed and validated pre- and postoperative risk scoring systems can estimate RFS after surgery for a single HCC. Key Points: • The risk scoring systems predicted RFS better than the BCLC and AJCC staging systems (C-index, 0.75–0.82 vs. 0.58–0.61; ps < 0.05). • Five variables—tumor size, targetoid appearance, radiologic tumor in vein or vascular invasion, the presence of a nonhypervascular hypointense nodule on the hepatobiliary phase, and pathologic macrovascular invasion—combined with tumor markers derived risk scoring systems predicting postsurgical RFS for a single HCC. • In the risk scoring system using preoperatively-available factors, patients were classified into three distinct risk groups, with 2-year recurrence rates in the low-, intermediate-, and high-risk groups being 3.3%, 31.8%, and 85.7% in the validation set. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-023-09539-7 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 14 StartPage: 3566 Subjects: – SubjectFull: Disease risk factors Type: general – SubjectFull: Tumor markers Type: general – SubjectFull: Hepatocellular carcinoma Type: general – SubjectFull: Alpha fetoproteins Type: general – SubjectFull: Systems development Type: general – SubjectFull: Proportional hazards models Type: general – SubjectFull: Clinical prediction rules Type: general – SubjectFull: Magnetic resonance imaging Type: general Titles: – TitleFull: Estimating postsurgical outcomes of patients with a single hepatocellular carcinoma using gadoxetic acid–enhanced MRI: risk scoring system development and validation. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Park, So Hyun – PersonEntity: Name: NameFull: Kim, Bohyun – PersonEntity: Name: NameFull: Kim, Sehee – PersonEntity: Name: NameFull: Park, Suyoung – PersonEntity: Name: NameFull: Park, Yeon Ho – PersonEntity: Name: NameFull: Shin, Seung Kak – PersonEntity: Name: NameFull: Sung, Pil Soo – PersonEntity: Name: NameFull: Choi, Joon-Il IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 33 – Type: issue Value: 5 Titles: – TitleFull: European Radiology Type: main |
| ResultId | 1 |
