Ruiz E., Honles J., Fernández R., Uribe K., Cerapio J. P., Cancino K., Contreras-Mancilla J., Casavilca-Zambrano S., Berrospi F., Pineau P., Bertani Stéphane. (2024). A preoperative risk score based on early recurrence for estimating outcomes after resection of hepatocellular carcinoma in the non-cirrhotic liver. HPB, 26 (5), 691-702. ISSN 1365-182X.
Titre du document
A preoperative risk score based on early recurrence for estimating outcomes after resection of hepatocellular carcinoma in the non-cirrhotic liver
Ruiz E., Honles J., Fernández R., Uribe K., Cerapio J. P., Cancino K., Contreras-Mancilla J., Casavilca-Zambrano S., Berrospi F., Pineau P., Bertani Stéphane
Source
HPB, 2024,
26 (5), 691-702 ISSN 1365-182X
Background: Liver resection is the mainstay treatment option for patients with hepatocellular carcinoma in the non-cirrhotic liver (NCL-HCC), but almost half of these patients will experience a recurrence within five years of surgery. Therefore, we aimed to develop a rationale-based risk evaluation tool to assist surgeons in recurrence-related treatment planning for NCL-HCC. Methods: We analyzed single-center data from 263 patients who underwent liver resection for NCLHCC. Using machine learning modeling, we first determined an optimal cut-off point to discriminate early versus late relapses based on time to recurrence. We then constructed a risk score based on preoperative variables to forecast outcomes according to recurrence-free survival. Results: We computed an optimal cut-off point for early recurrence at 12 months post-surgery. We identified macroscopic vascular invasion, multifocal tumor, and spontaneous tumor rupture as predictor variables of outcomes associated with early recurrence and integrated them into a scoring system. We thus stratified, with high concordance, three groups of patients on a graduated scale of recurrencerelated survival. Conclusion: We constructed a preoperative risk score to estimate outcomes after liver resection in NCL-HCC patients. Hence, this score makes it possible to rationally stratify patients based on recurrence risk assessment for better treatment planning.
