A preoperative risk score based on early recurrence for estimating outcomes after resection of hepatocellular carcinoma in the non-cirrhotic liver

• Autores: Ruiz, E, Honles, J, Fernández, R, Uribe, K, Cerapio, JP, Cancino, K, Contreras-Mancilla, J, Casavilca-Zambrano, S, Berrospi, F, Pineau, P, Bertani, S
• Formato: artículo
• Fecha de Publicación: 2024
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/385
• Enlace del recurso: https: //doi.org/10.1016/j.hpb.2024.02.010; https://hdl.handle.net/20.500.14703/385
• Nivel de acceso: acceso abierto
• Materia: Adult; Aged; Carcinoma, Hepatocellular; Female; Hepatectomy; Humans; Liver Neoplasms; Machine Learning; Male; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; https://purl.org/pe-repo/ocde/ford#3.02.21

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 NCL-HCC. 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 recurrence-related 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.