부산대학교 도서관

Xinxin Wang,1,* Yanyan Yu,1,* Yuqing Tao,2 Yueqi Wang,2 Chunhui Zhang,2 Yali Cui,3 Yang Zhou1 1Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China; 2Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China; 3Department of Nuclear Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yali Cui, Department of Nuclear Medicine, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, Heilongjiang, People’s Republic of China, Email yalicui68@126.com Yang Zhou, Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbi, Heilongjiang, People’s Republic of China, Email zhouyang094@126.comObjective: This study aims to identify independent risk factors for ultra-early recurrence in patients with early solitary hepatocellular carcinoma (HCC) and develop an individualized predictive nomogram for ultra-early recurrence.Materials and Methods: A total of 332 patients with early solitary HCC who underwent curative liver resection at our hospital from January 2015 to May 2021 were included in this study. Based on the patients’ recurrence status at 6 months, they were divided into the non-ultra-early recurrence group and the ultra-early recurrence group. Univariate and multivariate Cox regression analyses were used to construct the nomogram, and internal validation of its performance was performed using calibration plots with bootstrapping.Results: Among the 332 patients with early solitary HCC, 39 (11.7%) experienced ultra-early recurrence. Tumor morphology, age > 46 years, AFP > 332.4 ng/mL, GGT > 51.2 U/L, ALP > 126 U/L, PT > 12.8 s, and satellite nodules were identified as independent prognostic factors for ultra-early recurrence in patients with early solitary HCC and were incorporated into the final predictive nomogram. The C-index of the nomogram and bootstrap resampling were 0.842 and 0.815, respectively. The calibration plot demonstrated good agreement between the predicted and observed probabilities of ultra-early recurrence, and DCA indicated the favorable clinical utility of the nomogram. Additionally, AFP > 332.4 ng/mL, AST > 35 U/L, GGT > 51.2 U/L, ALP > 126 U/L, tumor morphology, tumor size, satellite nodules, and intratumoral hemorrhage were identified as risk factors for overall survival in patients with early solitary HCC.Conclusion: Our study establishes a nomogram for predicting the postoperative ultra-early recurrence status in patients with early solitary HCC, which provides valuable supplementary decision-making information for clinical decision-makers and guides the selection of the most appropriate treatment strategy.Keywords: hepatocellular carcinoma, hepatectomy, recurrence, risk factors, nomogram