Jun 2, 2012

Independent factors and predictive score for extrahepatic metastasis of hepatocellular carcinoma following curative hepatectomy

The Oncologist
Li JunShen Feng

Abstract

Postoperative extrahepatic metastasis (EHM) contributes to a poor prognosis in patients with hepatocellular carcinoma (HCC) after hepatectomy. This study was aimed to develop a practical method that can be used to predict postoperative EHM. In total, 578 patients were enrolled. We analyzed the clinicopathological features of the tumors and did a long-term follow-up to observe HCC recurrence. Postoperative EHM was detected in 136 patients, and multivariate analysis was used to confirm independent risk factors for postoperative EHM. After the factors were identified, a predictive scoring system was constructed as a weighted sum of these factors. The cutoff value that determines a high risk for EHM was defined by maximizing the Youden's index of the receiver operating characteristic curve. Microvascular invasion, incomplete capsule, and larger tumor diameter were the three independent factors predictive for a high risk for EHM. The scoring system was derived with an area under the curve (AUC) of 0.81 for postoperative 10-year EHM prediction. A cutoff value of 43 was derived and validated with a sensitivity >90% and specificity >60% to predict the development of EHM. This system was further verified in a subgroup of Barcelona Clini...Continue Reading

  • References35
  • Citations17

Mentioned in this Paper

Microbial Anatomical Capsule Structure
Liver Carcinoma
Neoplasms
Incidence Studies
Recurrent Malignant Neoplasm
Hepatocellular Carcinoma of the Mouse
Recurrence (Disease Attribute)
Hepatectomy
Subgroup A Nepoviruses
Neoplasm Metastasis

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