Risk Score Model for Microvascular Invasion in Hepatocellular Carcinoma: The Role of Tumor Burden and Alpha-Fetoprotein

Abstract

Microvascular invasion (MVI) is a significant risk factor for the recurrence of hepatocellular carcinoma, but it is a histological feature that needs to be confirmed after hepatectomy or liver transplantation. The preoperative prediction of MVI can optimize the treatment plan of HCC, but an easy and widely applicable model is still lacking. The aim of our study was to predict the risk of MVI using objective preoperative factors. We retrospectively collected 1153 patients who underwent liver resection for HCC, and MVI was found to be associated with significantly poor disease-free survival. The patients were randomly split in a 3:1 ratio into training (n = 864) and validation (n = 289) datasets. The multivariate analysis of the training dataset found preoperative total tumor volume (TTV) and alpha-fetoprotein (AFP) to be independent risk factors for MVI. We built a risk score model with cutoff points of TTV at 30, 60, and 300 cm3 and AFP at 160 and 2000 ng/mL, and the model stratified the risk of MVI into low risk (14.1%), intermediate risk (36.4%), and high risk (60.5%). The validation of the risk score model with the validation dataset showed moderate performance (the concordance statistic: 0.731). The model comprised simple and objective preoperative factors with good applicability, which can help to guide treatment plans for HCC and future study design.

Characterization of Gut Microbiota and Exploration of Potential Predictive Model for Hepatocellular Carcinoma Microvascular Invasion

“…Therefore, preoperative prediction of MVI, especially in a non-invasive manner, is of great significance. Several studies have evaluated the performance of MVI predictive models constructed with clinical and molecular indicators, and the AUC of these models ranged from 0.73 to 0.81, suggesting that higher specificity and sensitivity are crucial for future studies (29)(30)(31). Intestinal microbiome analysis becomes an important direction for predictive model construction considering its convenience and non-invasive sample collecting requirements.…”

Identify optimal HAP series scores for unresectable HCC patients undergoing TACE plus sorafenib: A Chinese multicenter observational study

“…To the best of our knowledge, PVTT and EHS reflect the aggressiveness of HCC and have been deemed as negative prognostic predictors in different staging systems (24)(25)(26)(27). Beyond the guideline recommendation, TACE-S has been widely used to manage uHCC patients with PVTT and EHS in real-world clinical practice.…”

Adjuvant transarterial chemoembolization timing after radical resection is an independent prognostic factor for patients with hepatocellular carcinoma

“…Tumor size plays an important role in predicting HCC progression, and the risk of recurrence increases significantly as the tumor grows ( 65 , 66 ). MVI is now widely used as a tool for assessing tumor aggressiveness and has been proven to be correlated with tumor recurrence and prognosis ( 67 , 68 ). The nomogram model is more accurate in predicting RFS at 1, 3, and 5 years than individual clinicopathological risk factors.…”