Liver stiffness value-based risk estimation of late recurrence after curative resection of hepatocellular carcinoma: development and validation of a predictive model

Preoperative liver stiffness (LS) measurement using transient elastography (TE) is useful for predicting late recurrence after curative resection of hepatocellular carcinoma (HCC). We developed and validated a novel LS value-based predictive model for late recurrence of HCC. Patients who were due to...

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Bibliographic Details
Published in:PloS one 2014-06, Vol.9 (6), p.e99167
Main Authors: Jung, Kyu Sik, Kim, Ji Hong, Kim, Seung Up, Song, Kijun, Kim, Beom Kyung, Park, Jun Yong, Kim, Do Young, Ahn, Sang Hoon, Moon, Do Chang, Song, In Ji, Choi, Gi Hong, Park, Young Nyun, Han, Kwang-Hyub
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Area Under Curve
Calibration
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Confidence intervals
Correlation coefficient
Correlation coefficients
Diagnostic Imaging
Female
Follow-Up Studies
Hepatocellular carcinoma
Humans
Liver
Liver - pathology
Liver - surgery
Liver cancer
Liver diseases
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medicine and Health Sciences
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local - diagnosis
Patients
Physicians
Prognosis
Prospective Studies
Quality
Regression analysis
Regression models
Risk
Risk Factors
Satellite communications
Statistical analysis
Statistical methods
Stiffness
Studies
Surgery
Tumors
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Summary:Preoperative liver stiffness (LS) measurement using transient elastography (TE) is useful for predicting late recurrence after curative resection of hepatocellular carcinoma (HCC). We developed and validated a novel LS value-based predictive model for late recurrence of HCC. Patients who were due to undergo curative resection of HCC between August 2006 and January 2010 were prospectively enrolled and TE was performed prior to operations by study protocol. The predictive model of late recurrence was constructed based on a multiple logistic regression model. Discrimination and calibration were used to validate the model. Among a total of 139 patients who were finally analyzed, late recurrence occurred in 44 patients, with a median follow-up of 24.5 months (range, 12.4-68.1). We developed a predictive model for late recurrence of HCC using LS value, activity grade II-III, presence of multiple tumors, and indocyanine green retention rate at 15 min (ICG R15), which showed fairly good discrimination capability with an area under the receiver operating characteristic curve (AUROC) of 0.724 (95% confidence intervals [CIs], 0.632-0.816). In the validation, using a bootstrap method to assess discrimination, the AUROC remained largely unchanged between iterations, with an average AUROC of 0.722 (95% CIs, 0.718-0.724). When we plotted a calibration chart for predicted and observed risk of late recurrence, the predicted risk of late recurrence correlated well with observed risk, with a correlation coefficient of 0.873 (P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0099167