A nomogram for preoperative prediction of vessels encapsulating tumor clusters (VETC) pattern and prognosis of hepatocellular carcinoma

Yinzhong Wang; Miaomiao Wang; Liang Cao; Hongliang Huang; Shi Cao; Xiaoxue Tian; Junqiang Lei

doi:10.1016/j.amjsurg.2024.05.004

A nomogram for preoperative prediction of vessels encapsulating tumor clusters (VETC) pattern and prognosis of hepatocellular carcinoma

Am J Surg. 2024 May 5:S0002-9610(24)00270-8. doi: 10.1016/j.amjsurg.2024.05.004. Online ahead of print.

Authors

Yinzhong Wang¹, Miaomiao Wang², Liang Cao¹, Hongliang Huang¹, Shi Cao³, Xiaoxue Tian⁴, Junqiang Lei⁵

Affiliations

¹ Department of Radiology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou City, Gansu Province, China.
² The First Clinical Medical College of Lanzhou University, No.1 Donggang West Road, Lanzhou City, Gansu Province, China.
³ Department of Pathology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou City, Gansu Province, China.
⁴ Department of Nuclear Medicine, Second Hospital of LanZhou University, No.82, Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China.
⁵ Department of Radiology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou City, Gansu Province, China. Electronic address: leijq2011@126.com.

PMID: 38755026
DOI: 10.1016/j.amjsurg.2024.05.004

Abstract

Background: Vessels encapsulating tumor clusters (VETC) pattern of hepatocellular carcinoma (HCC) are associated with unfavorable prognosis. This study aimed to establish a nomogram model to predict VETC patterns based on preoperative CT imaging features.

Patients and methods: Patients who underwent surgical resection between January 1, 2016 and August 31, 2022 were retrospectively included. Predictors associated with VETC pattern were determined by using logistic regression analyses, and a nomogram model was constructed. Prognostic factors associated with recurrence-free survival (RFS) after surgical resection were identified by using Cox regression analyses.

Results: A total of 84 patients were included for CT analysis. All patients underwent radical surgical resection. AST/ALT >1.07(odds ratio [OR], 4.91; 95 % CI: 1.11, 21.68; P < 0.05), intratumoral necrosis (OR, 4.99; 95 % CI: 1.25, 19.99; P < 0.05) and enhancing capsule (OR, 3.32; 95 % CI: 1.27, 8.94; P < 0.05) were independent predictors of VETC pattern. These features were used for the construction of nomogram model, which showed comparable prediction performance, with AUC value of 0.767 (95%CI [0.662, 0.852]). CK19 status (Hazard ratio [HR], 2.02; 95 % CI: 1.06, 3.86; P < 0.05), the number of tumors (HR, 3.31; 95 % CI: 1.47, 7.45; P < 0.05) and VETC pattern (HR, 2.52; 95 % CI: 1.31, 4.86; P < 0.05) were independent predictors of postoperative RFS.

Conclusion: A nomogram model based on preoperative CT imaging features could be used for the characterization of VETC pattern, and has prognostic significance for postoperative RFS in patients with HCC.

Keywords: Diagnosis; Hepatocellular carcinoma(HCC); Nomogram; Prognosis; Vessels encapsulating tumor clusters (VETC).