Establishment and validation of a predictive model of recurrence in primary hepatocellular carcinoma after resection

Abstract

Background: In recent years, nomogram prediction models have been widely used to evaluate the prognosis of various diseases. However, studies in primary hepatocellular carcinoma (HCC) are limited. This study sought to explore the risk factors of recurrence of patients with primary HCC after surgical resection and establish a nomogram prediction model. Methods:The data of 424 patients with primary HCC who had been admitted to the Wuhan Third Hospital were retrospectively collected. The patients were followed-up for 5 years after surgery. The patients were divided into the recurrence group (n=189) and control group (n=235) according to whether the cancer recurred after surgery. The differences in the clinical characteristics between the two groups were analyzed.The risk factors of recurrence after surgical resection of primary HCC were also analyzed, and a prediction model was then established using R4.0.3 statistical software.Results: There were significant statistical differences between the two groups in terms of the tumor size, systemic immune-inflammation (SII) index, the number of lesions, tumor differentiation degree, ascites, vascular invasion, and portal vein tumor thrombus (P<0.05). The multivariate regression analysis showed that multiple foci, poorly differentiated tumors, ascites, vascular invasion, and portal vein tumor thrombus were risk factors for the recurrence of primary HCC in patients after surgical resection (P<0.05). The data set was randomly divided into a training set and verification set. The sample size of the training set was 297, and the sample size of the verification set was 127. The area under the receiver operating characteristic (ROC) curve of the training set was 0.866 [95% confidence interval (CI): 0.824-0.907], and the area under the ROC curve of the validation set was 0.812 (95% CI: 0.734-0.890). The Hosmer-Lemeshow Goodness-of-Fit Test was used to test the model with the validation set (χ 2 =11.243, P=0.188), which indicated that the model had high value in predicting the recurrence of primary HCC after surgical resection.Conclusions: This model had high value in predicting the recurrence of primary HCC in patients after surgical resection. This model could assist clinicians to assess the prognosis of patients. Intensive treatment for high-risk patients might improve the prognosis of patients.

Construction and validation of a novel prognostic model for intrahepatic cholangiocarcinoma based on a combined scoring system of systemic immune-inflammation index and albumin-bilirubin: a multicenter study

“…On the other hand, lymphocytes play a crucial role in cell-mediated immune destruction of cancer cells by activated T cells and other lymphocytes, while tumors can also release cytokines such as IFN-γ and TNF-α to regulate various immune functions in the body ( 20 , 21 ). Furthermore, numerous studies have confirmed that SII is an independent prognostic factor for postoperative survival in various digestive system malignancies, including HCC, ICC, and gallbladder cancer ( 8 , 22 – 25 ). Similarly, in our study, a lower SII was significantly associated with improved postoperative survival and reduced recurrence rates, further validating this observation.…”