Early risk warning system for distant metastasis of hepatitis B virus‑associated hepatocellular carcinoma with portal vein tumor thrombus

Abstract

Portal vein tumor thrombus (PVTT) promotes distant metastasis of hepatocellular carcinoma (HCC), which increases the mortality of patients with HCC and PVTT. The aim of the present study was to develop an early risk warning system for distant metastasis of hepatitis B virus (HBV)-associated primary HCC (HBV-HCC) with PVTT. Data from 346 patients (263 and 83 in the modeling and validation cohorts, respectively) who had received primary diagnoses of HBV-HCC and PVTT between January 2012 and June 2015 at Beijing Ditan Hospital (Beijing, China) were retrospectively examined. In the modeling cohort, univariate and multivariate logistic regression analyses were conducted to determine the factors that were significantly associated with distant metastasis. Furthermore, an early risk warning model for distant metastasis was proposed and validated through receiver operating characteristic curve analysis in the validation cohort. The results revealed that neutrophil to lymphocyte ratios of ≥2.31, red blood cell counts of ≥4.07x10 12 cells/l, C-reactive protein levels of ≥7.02 mg/l, aspartate aminotransferase levels of ≥118.5 U/l and tumor thrombus site (at branch) were significantly positively associated with distant metastasis of HBV-HCC with PVTT (P<0.05; odds ratio >1.000). A formula for predicting distant metastasis was obtained with an accuracy of ~70%. The results of the present study may allow for the early prediction of distant metastasis and facilitate the administration of appropriate treatment to improve the outcomes and prognosis of patients with intermediate to advanced HCC.

Development and Validation of a Machine Learning Prognostic Model for Hepatocellular Carcinoma Recurrence After Surgical Resection

“…Firstly, previous studies found that patients with portal vein tumor thrombosis (PVTT) usually decreased liver function reserves, which was a high-risk factor for disease progression and recurrence ( 29 , 30 ). In addition to tumor thrombus, tumor volume is also associated with HCC recurrence.…”

Development and Validation of a Novel Prognostic Nomogram Based on Platelet and CD8+T Cell Counts in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis

“… 37 In addition, patients with PVTT who did not develop distant tumor metastases were more likely to exhibit thrombocytopenia than those who did. 38 In the reverse direction, a major study of the Lancet concluded that antiplatelet therapy could inhibit tumor metastasis and improve patient prognosis, but the survival rate of the low-concentration drug group was significantly higher than that of the high-concentration group. 39 These support our findings that thrombocytopenia may be an important prognostic factor in patients with PVTT.…”

Nomogram for the Preoperative Prediction of the Macrotrabecular-Massive Subtype of Hepatocellular Carcinoma

“… 32 , 33 It has been reported that AST levels ≥118.5 U/L are significantly associated with distant metastasis of primary HCC with portal vein tumour thrombus (PVTT). 34 An AST level of ≥2× the upper limit of normal (ULN) is an independent indicator for poor prognosis. 35 These studies demonstrated that elevated AST levels are closely related to the prognosis of HCC and are an independent risk factor for poor prognosis.…”