Detailed Abstract
[Poster Presentation 3 - Liver (Liver Disease/Surgery)]
[PP 3-1] DEVELOPMENT AND VALIDATION OF A RISK STRATIFICATION MODEL FOR POST-HEPATECTOMY DISTANT METASTASIS IN HEPATOCELLULAR CARCINOMA: A MULTI-CENTER STUDY
Ming-Da WANG 1, Yong-Kang DIAO 1, Fu-Jie CHEN 1, Yu-Chen LI 1, Wei-Min GU 2, Hong WANG 3, Yuze YANG 4, Yong-Yi ZENG 5, Ya-Hao ZHOU 6, Xian-Ming WANG 7, Jie LI 8, Ting-Hao CHEN 9, Ying-Jian LIANG 10, Jia-Hao XU 1, Tian YANG 1
1 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China, China, 2 The First Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang, China, China, 3 Department of General Surgery, Liuyang People’s Hospital, Hunan, China, China, 4 Department of Hepatobiliary And Pancreatic Surgery, First Hospital of Jilin University, Changchun, China, China, 5 Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fujian, China, China, 6 Department of Hepatobiliary Surgery, Pu’er People’s Hospital, Yunnan, China, China, 7 Department of General Surgery, First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong, China, China, 8 Department of Hepatobiliary Surgery, Fuyang People’s Hospital, Anhui, China, China, 9 Department of Hepatobiliary Surgery, Ziyang First People’s Hospital, Sichuan, China, China, 10 Department of Hepatobiliary Surgery, First Affiliated Hospital of Harbin Medical University, Heilongjiang, China, China
Background : Despite advances in surgical techniques for hepatocellular carcinoma (HCC), the occurrence of distant metastasis following curative hepatectomy remains a significant challenge that substantially impacts patient survival. Currently, there is a lack of reliable tools to identify patients at high risk for post-operative distant metastasis, limiting the ability to implement targeted surveillance and early intervention strategies.
Methods : A comprehensive analysis of 2,705 HCC patients who underwent hepatectomy across multiple institutions between 2013 and 2020 was conducted. Using statistical modeling, we integrated clinicopathological variables to identify key predictors of distant metastasis. A novel risk prediction nomogram was developed and validated through rigorous statistical methods, including concordance index calculation and calibration curve analysis. Risk stratification was performed by categorizing patients into three distinct risk groups based on calculated nomogram scores.
Results : Among the study cohort, 342 patients (22.7%) developed distant metastasis as their initial recurrence pattern. Eight independent risks emerged from our analysis: preoperative tumor rupture, tumor diameter exceeding 5 cm, multinodular disease, presence of satellite lesions, macro- and microvascular invasion, surgical margin status, and perioperative blood product administration. The constructed nomogram exhibited exceptional discriminatory ability (C-index >0.85) in predicting distant metastasis risk. Long-term survival analysis revealed striking differences among risk groups, with 5-year overall survival rates of 9.1%, 41.1%, and 90.8% for patients with distant metastasis, intrahepatic recurrence, and no recurrence, respectively (P<0.001).
Conclusions : This validated risk stratification model provides clinicians with a practical tool for identifying HCC patients at elevated risk for distant metastasis, enabling personalized surveillance protocols and timely therapeutic interventions.
Methods : A comprehensive analysis of 2,705 HCC patients who underwent hepatectomy across multiple institutions between 2013 and 2020 was conducted. Using statistical modeling, we integrated clinicopathological variables to identify key predictors of distant metastasis. A novel risk prediction nomogram was developed and validated through rigorous statistical methods, including concordance index calculation and calibration curve analysis. Risk stratification was performed by categorizing patients into three distinct risk groups based on calculated nomogram scores.
Results : Among the study cohort, 342 patients (22.7%) developed distant metastasis as their initial recurrence pattern. Eight independent risks emerged from our analysis: preoperative tumor rupture, tumor diameter exceeding 5 cm, multinodular disease, presence of satellite lesions, macro- and microvascular invasion, surgical margin status, and perioperative blood product administration. The constructed nomogram exhibited exceptional discriminatory ability (C-index >0.85) in predicting distant metastasis risk. Long-term survival analysis revealed striking differences among risk groups, with 5-year overall survival rates of 9.1%, 41.1%, and 90.8% for patients with distant metastasis, intrahepatic recurrence, and no recurrence, respectively (P<0.001).
Conclusions : This validated risk stratification model provides clinicians with a practical tool for identifying HCC patients at elevated risk for distant metastasis, enabling personalized surveillance protocols and timely therapeutic interventions.
SESSION
Poster Presentation 3
Exhibition Hall 3/27/2025 2:50 PM - 3:30 PM