Association of Preoperative Antiviral Treatment With Incidences of Microvascular Invasion and Early Tumor Recurrence in Hepatitis B Virus–Related Hepatocellular Carcinoma

Li, Zheng; Lei, Zhengqing; Xia, Yong; Li, Jun; Wang, Kui; Zhang, Han; Wan, Xia; Yang, Tian; Zhou, Weiping; Wu, Mengchao; Pawlik, Timothy M.; Lau, Wan Yee

doi:10.1001/jamasurg.2018.2721

Cited by 86 publications

(74 citation statements)

References 56 publications

(68 reference statements)

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“…Our study covers both patients with viral hepatitis and non-viral hepatitis, while the majority of previous studies focus on HBV-related HCC [ 33 , 42 , 43 ]. ROC curves in subgroup analysis shows relatively satisfactory discriminative performance of the nomogram model regardless of the HBV infection status, indicating that our findings might be comparably suitable for HCC developed from both viral hepatitis and non-viral hepatitis.…”

Section: Discussionmentioning

confidence: 99%

Preoperative prediction of microvascular invasion in non-metastatic hepatocellular carcinoma based on nomogram analysis

Zhang

Zhao

Chen

et al. 2021

Translational Oncology

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Purpose The presence of microvascular invasion (MVI) is an unfavorable prognostic factor for hepatocellular carcinoma (HCC). This study aimed to construct a nomogram-based preoperative prediction model of MVI, thereby assisting to preoperatively select proper surgical procedures. Methods A total of 714 non-metastatic HCC patients undergoing radical hepatectomy were retrospectively selected from Zhongshan Hospital between 2010 and 2018, followed by random assignment into training (N = 520) and validation cohorts (N = 194). Nomogram-based prediction model for MVI risk was constructed by incorporating independent risk factors of MVI presence identified from multivariate backward logistic regression analysis in the training cohort. The performance of nomogram was evaluated by calibration curve and ROC curve. Finally, decision curve analysis (DCA) was used to determine the clinical utility of the nomogram. Results In total, 503 (70.4%) patients presented MVI. Multivariate analysis in the training cohort revealed that age (OR: 0.98), alpha-fetoprotein (≥400 ng/mL) (OR: 2.34), tumor size (>5 cm) (OR: 3.15), cirrhosis (OR: 2.03) and γ-glutamyl transpeptidase (OR: 1.61) were significantly associated with MVI presence. The incorporation of five risk factors into a nomogram-based preoperative estimation of MVI risk demonstrated satisfactory discriminative capacity, with C-index of 0.702 and 0.690 in training and validation cohorts, respectively. Calibration curve showed good agreement between actual and predicted MVI risks. Finally, DCA revealed the clinical utility of the nomogram. Conclusion The nomogram showed a satisfactory discriminative capacity of MVI risk in HCC patients, and could be used to preoperatively estimate MVI risk, thereby establishing more rational therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Preoperative prediction of microvascular invasion in non-metastatic hepatocellular carcinoma based on nomogram analysis

Zhang

Zhao

Chen

et al. 2021

Translational Oncology

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“…Based on a study of 2,362 patients who underwent resection for CHB-related HCC (326 patients receiving antiviral treatment; 2,036 not receiving antiviral treatment), Li et al found that the group with antiviral treatment had better survival than the control group (5-year overall survival rate 69.1% vs. 56.3%; p <0.001). 27 Interestingly, post-HCC NA, which may be regarded as a 'delay' in suppressing the virus, had benefited HCC patients in a similar degree to those who had been taking NA before HCC occurrence. This observation gives a positive motivation to doctors and patients that it is never too late to start NA treatment as tertiary prophylaxis of HCC.…”

Section: Discussionmentioning

confidence: 99%

Increasing antiviral treatment uptake improves survival in patients with HBV-related HCC

et al. 2020

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“…The cut‐off value of HBV‐DNA load was defined as depicted in a previous paper . Microvascular invasion(MVI) was determined based upon tumor cell nests present in small branches of hepatic and portal veins and lymphatic ducts on microscopy .…”

Section: Methodsmentioning

confidence: 99%

Nomograms to predict the long‐time prognosis in patients with alpha‐fetoprotein negative hepatocellular carcinoma following radical resection

Huang

Liu

et al. 2020

Cancer Medicine

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Background:To develop and validate nomograms that can be used to predict outcomes in individuals suffering alpha-fetoprotein (AFP) negative hepatocellular carcinoma (HCC) after radical resection. Methods: A total of 509 AFP-negative HCC patients who in our center were randomized into training and validation cohorts. Nomograms for both overall and recurrence-free survival (OS and RFS, respectively) were established based on the predictors in the training cohort. Nomograms performance and discriminative power were assessed with concordance index (C-index) values and decision curve analyses (DCA). The results were validated in the validation cohort. Results: Alkaline phosphatase, liver cirrhosis, tumor size, satellite lesions, microvascular invasion, and Edmondson-Steiner grade were significantly linked to OS and RFS. Sex and tumor number were additional predictors for RFS. The OS nomogram had a C-index value of 0.742, which was better than that for the AJCC eighth edition (0.632), BCLC system (0.553), and JIS score (0.557) (all P < .001). The RFS nomogram C-index was 0.669, which was also superior to that of the AJCC eighth (0.608), BCLC stage (0.554), JIS score (0.551), and model of Gan et al (0.636) (P < .05 for all). Calibration curves indicated a good agreement between observed actual outcomes and predicted values. Kaplan-Meier curves and DCA indicated that nomograms were powerful in discrimination and clinical usefulness. These results were supported by the validation cohort. Conclusions: These nomograms presented more accurate prognostic prediction in patients with AFP-negative HCC after hepatectomy. K E Y W O R D Salpha-fetoprotein, carcinoma, hepatectomy, hepatocellular, nomogram 2792 | HUANG et Al.

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Association of Preoperative Antiviral Treatment With Incidences of Microvascular Invasion and Early Tumor Recurrence in Hepatitis B Virus–Related Hepatocellular Carcinoma

Abstract: A high preoperative HBV DNA level was an independent risk factor of MVI. Antiviral treatment administered more than 90 days before surgery was associated with reduced incidences of MVI and early tumor recurrence after partial hepatectomy for HBV-related HCC.

Cited by 86 publications

References 56 publications

Preoperative prediction of microvascular invasion in non-metastatic hepatocellular carcinoma based on nomogram analysis

Preoperative prediction of microvascular invasion in non-metastatic hepatocellular carcinoma based on nomogram analysis

Increasing antiviral treatment uptake improves survival in patients with HBV-related HCC

Nomograms to predict the long‐time prognosis in patients with alpha‐fetoprotein negative hepatocellular carcinoma following radical resection

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