Comprehensive radiomics nomogram for predicting survival of patients with combined hepatocellular carcinoma and cholangiocarcinoma.

World J Gastroenterol

Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, West China Hospital, Chengdu 610041, Sichuan Province, China.

Published: November 2021

AI Article Synopsis

  • The study focuses on a specific type of liver cancer known as combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CCA), which has a poor survival outlook.
  • Researchers aimed to create a nomogram using radiomics data from CT scans to predict survival rates for patients after liver surgery.
  • The resulting nomogram demonstrated strong predictive capabilities, integrating various clinical factors and radiomics scores, and showed that patients identified as high-risk had significantly shorter overall survival compared to low-risk patients.

Article Abstract

Background: Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (cHCC-CCA) is defined as a single nodule showing differentiation into HCC and intrahepatic cholangiocarcinoma and has a poor prognosis.

Aim: To develop a radiomics nomogram for predicting post-resection survival of patients with cHCC-CCA.

Methods: Patients with pathologically diagnosed cHCC-CCA were randomly divided into training and validation sets. Radiomics features were extracted from portal venous phase computed tomography (CT) images using the least absolute shrinkage and selection operator Cox regression and random forest analysis. A nomogram integrating the radiomics score and clinical factors was developed using univariate analysis and multivariate Cox regression. Nomogram performance was assessed in terms of the C-index as well as calibration, decision, and survival curves.

Results: CT and clinical data of 118 patients were included in the study. The radiomics score, vascular invasion, anatomical resection, total bilirubin level, and satellite lesions were found to be independent predictors of overall survival (OS) and were therefore included in an integrative nomogram. The nomogram was more strongly associated with OS (hazard ratio: 8.155, 95% confidence interval: 4.498-14.785, < 0.001) than a model based on the radiomics score or only clinical factors. The area under the curve values for 1-year and 3-year OS in the training set were 0.878 and 0.875, respectively. Patients stratified as being at high risk of poor prognosis showed a significantly shorter median OS than those stratified as being at low risk (6.1 81.6 mo, < 0.001).

Conclusion: This nomogram may predict survival of cHCC-CCA patients after hepatectomy and therefore help identify those more likely to benefit from surgery.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613648PMC
http://dx.doi.org/10.3748/wjg.v27.i41.7173DOI Listing

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