A nomogram based on Gadoxetic Acid-enhanced MRI for prediction of postoperative recurrence of micro-vascular invasion-negative hepatocellular carcinoma
A nomogram based on Gadoxetic Acid-enhanced MRI for prediction of postoperative recurrence of micro-vascular invasion-negative hepatocellular carcinoma
Objective:To investigate the value of a nomogram based on Gadoxetic Acid(Gd-EOB-DTPA)enhanced MRI in predicting recurrence-free survival(RFS)after radical hepatectomy in patients with microvascular invasion(MVI)-negative hepatocellular carcinoma(HCC).Methods:A to-tal of 125 patients with pathologically proved MVI negative HCC who underwent radical hepatectomy from February 2015 to May 2021 were retrospectively enrolled in this study.The preoperative clinical data,MRI images and postoperative pathological data were analyzed.Univariate and multivariate Cox proportional hazards models were used to analyze postoperative independent risk factors for RFS,and a nomogram was constructed to predict 1,3,and 5-year RFS.C-index and receiver operating character-istic(ROC)curve were used to evaluate the predictive ability of the nomogram,and calibration curve was used to evaluate the model's consistency.Results:During follow-up,37 HCC patients relapsed,with a median RFS of 27.1 months[95％confidence interval(CI):43.3～54.1 months].RFS were 88.0％,71.9％and 45.9％at 1,3 and 5 years after operation,respectively.Multivariate analysis showed that HCC pathological grade[hazard ratio(HR)=4.807,95％CI:1.126～20.526,P=0.034],peritumoral hypointensity on hepatobiliary phase(HR=3.755,95％CI:1.736～8.122,P=0.001)and the relative intensity ratio(RIR)in hepatobiliary phase(HR=0.019,95％CI:0.001～0.396,P=0.010)were in-dependent risk factors for postoperative RFS.A nomogram integrating the above three variables,the area under the curve(AUC)was 0.819(95％CI:0.740～0.882,P＜0.001),in addition,with bootstrap internal verification,the model C-index was 0.795(95％CI:0.723～0.867),and the calibration curve verification result shows that the predicted probability and the actual observed probability of the mod-el agree well.Conclusion:The nomogram model based on Gd-EOB-DTPA-enhanced MRI can effectively predict the postoperative RFS of MVI-negative HCC patients.
维普
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