机构：[1]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai,[2]Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China,华中科技大学同济医学院附属同济医院[3]Department of Medical and Surgical Sciences, General Surgery and Transplantation Unit, University of Bologna, Italy,[4]Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong Special Administrative Region,[5]Department of Hepatobiliary Surgery, Pu’er People’s Hospital, Yunnan,[6]The First Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang,[7]Department of General Surgery, Liuyang People’s Hospital, Hunan,[8]Department of General Surgery, Ziyang First People’s Hospital, Sichuan,[9]Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fujian, China,[10]Liver Cancer Program, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York[11]Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, OH, United States
Background: A clear definition of "early recurrence" after hepatocellular carcinoma (HCC) resection is still lacking. This study aimed to determine the optimal cutoff between early and late HCC recurrence, and develop nomograms for pre- and postoperative prediction of early recurrence. Methods: Patients undergoing HCC resection were identified from a multi-institutional Chinese database. Minimum P-value approach was adopted to calculate optimal cut-off to define early recurrence. Pre- and postoperative risk factors for early recurrence were identified and further used for nomogram construction. The results were externally validated by a Western cohort. Results: Among 1501 patients identified, 539 (35.9%) were recurrence-free. The optimal length to distinguish between early (n = 340, 35.3%) and late recurrence (n = 622, 64.7%) was 8 months. Multivariable logistic regression analyses identified 5 preoperative and 8 postoperative factors for early recurrence, which were further incorporated into preoperative and postoperative nomograms (C-index: 0.785 and 0.834). The calibration plots for the probability of early recurrence fitted well. The nomogram performance was maintained using the validation dataset (C-index: 0.777 for preoperative prediction and 0.842 for postoperative prediction). Conclusions: An interval of 8 months was the optimal threshold for defining early HCC recurrence. The two web-based nomograms have been published to allow accurate pre- and postoperative prediction of early recurrence. These may offer useful guidance for individual treatment or follow up for patients with resectable HCC.
基金：
Funding for the study was provided by the National Natural Science Foundation
of China (No. 81672699 and 81972726, Dr Yang) and Shanghai Pujiang
Program (No. 16PJD004, Dr Yang).
第一作者机构：[1]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai,
共同第一作者：
通讯作者：
通讯机构：[1]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai,[*1]Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai, 200438, China.
推荐引用方式(GB/T 7714)：
Hao Xing,Wan-Guang Zhang,Matteo Cescon,et al.Defining and predicting early recurrence after liver resection of hepatocellular carcinoma: a multi-institutional study[J].HPB.2020,22(5):677-689.doi:10.1016/j.hpb.2019.09.006.
APA：
Hao Xing,Wan-Guang Zhang,Matteo Cescon,Lei Liang,Chao Li...&Tian Yang.(2020).Defining and predicting early recurrence after liver resection of hepatocellular carcinoma: a multi-institutional study.HPB,22,(5)
MLA：
Hao Xing,et al."Defining and predicting early recurrence after liver resection of hepatocellular carcinoma: a multi-institutional study".HPB 22..5(2020):677-689
