New insights into a microvascular invasion prediction model in hepatocellular carcinoma: A retrospective study from the SEER database and China

Abstract

Background and AimsThe prognosis of liver cancer is strongly influenced by microvascular infiltration (MVI). Accurate preoperative MVI prediction can aid clinicians in the selection of suitable treatment options. In this study, we constructed a novel, reliable, and adaptable nomogram for predicting MVI.MethodsUsing the Surveillance, Epidemiology, and End Results (SEER) database, we extracted the clinical data of 1,063 patients diagnosed with hepatocellular carcinoma (HCC) and divided it into either a training (n = 739) or an internal validation cohort (n = 326). Based on multivariate analysis, the training cohort data were analyzed and a nomogram was generated for MVI prediction. This was further verified using an internal validation cohort and an external validation cohort involving 293 Chinese patients. Furthermore, to evaluate the efficacy, accuracy, and clinical use of the nomogram, we used concordance index (C-index), calibration curve, and decision curve analysis (DCA) techniques.ResultsIn accordance with the multivariate analysis, tumor size, tumor number, alpha-fetoprotein (AFP), and histological grade were independently associated with MVI. The established model exhibited satisfactory performance in predicting MVI. The C-indices were 0.719, 0.704, and 0.718 in the training, internal validation, and external validation cohorts, respectively. The calibration curves showed an excellent consistency between the predictions and actual observations. Finally, DCA demonstrated that the newly developed nomogram had favorable clinical utility.ConclusionsWe established and verified a novel preoperative MVI prediction model in HCC patients. This model can be a beneficial tool for clinicians in selecting an optimal treatment plan for HCC patients.

Exploring the factors affecting the occurrence of postoperative MVI and the prognosis of hepatocellular carcinoma patients treated with hepatectomy: A multicenter retrospective study

“…Studies 24,25 have shown that the size of the tumor is a significant risk factor for the emergence of MVI and postoperative recurrence of HCC. The incidence of MVI and postoperative recurrence in HCC patients increases progressively with increasing tumor diameter 26 . Tumor size was separated into three groups in this study, with cutoff values of 20 and 50 mm.…”

Preoperative prediction of microvascular invasion in hepatocellular carcinoma using ultrasound features including elasticity

“…Our results also showed that the maximal diameters of MVI-positive HCCs were significantly larger than those of MVI-negative HCC, and a larger maximal diameter was an independent risk factor for MVI-positive HCCs with an odds ratio of 1.021. Tumor size is an established independent prognostic factor for HCC[ 20 , 21 ]. Our research has revealed that HCC size was also an independent prognostic factor for positive MVI.…”