Abstract
Background
Prediction models with or without radiomic analysis for microvascular invasion (MVI) in hepatocellular carcinoma (HCC) have been reported, but the potential for model-predicted MVI in surgical planning is unclear. Therefore, we aimed to explore the effect of predicted MVI on early recurrence after anatomic resection (AR) and non-anatomic resection (NAR) to assist surgical strategies.
Methods
Patients with a single HCC of 2–5 cm receiving curative resection were enrolled from 2 centers. Their data were used to develop (n = 230) and test (n = 219) two prediction models for MVI using clinical factors and preoperative computed tomography images. The two prediction models, clinico-radiologic model and clinico-radiologic-radiomic (CRR) model (clinico-radiologic variables + radiomic signature), were compared using the Delong test. Early recurrence based on model-predicted high-risk MVI was evaluated between AR (n = 118) and NAR (n = 85) via propensity score matching using patient data from another 2 centers for external validation.
Results
The CRR model showed higher area under the curve values (0.835–0.864 across development, test, and external validation) but no statistically significant improvement over the clinico-radiologic model (0.796–0.828). After propensity score matching, difference in 2-year recurrence between AR and NAR was found in the CRR model predicted high-risk MVI group (P = 0.005) but not in the clinico-radiologic model predicted high-risk MVI group (P = 0.31).
Conclusions
The prediction model incorporating radiomics provided an accurate preoperative estimation of MVI, showing the potential for choosing the more appropriate surgical procedure between AR and NAR.
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Acknowledgments
This research was supported by the National Natural Science Foundation of China (NSFC, No. 81830053, 92059202, and 61821002), the Postgraduate Research & Practice Innovation Program of Jiangsu Province (KYCX21_0153), and the Key Research and Development Program of Jiangsu Province (BE2020717).
Funding
This research was supported by the National Natural Science Foundation of China (NSFC, No. 81830053, 92059202, and 61821002), the Postgraduate Research & Practice Innovation Program of Jiangsu Province (KYCX21_0153), and the Key Research and Development Program of Jiangsu Province (BE2020717).
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Meng, XP., Tang, TY., Ding, ZM. et al. Preoperative Microvascular Invasion Prediction to Assist in Surgical Plan for Single Hepatocellular Carcinoma: Better Together with Radiomics. Ann Surg Oncol 29, 2960–2970 (2022). https://doi.org/10.1245/s10434-022-11346-1
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DOI: https://doi.org/10.1245/s10434-022-11346-1