Tang YY, Zhao YN, Zhang T, Chen ZY, Ma XL. Comprehensive radiomics nomogram for predicting survival of patients with combined hepatocellular carcinoma and cholangiocarcinoma. World J Gastroenterol 2021; 27(41): 7173-7189 [PMID: 34887636 DOI: 10.3748/wjg.v27.i41.7173]
Corresponding Author of This Article
Zhe-Yu Chen, PhD, Chief Doctor, Full Professor, Postdoc, Surgeon, Surgical Oncologist, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, No. 37 Guoxue Street, Wuhou District, Chengdu 610041, Sichuan Province, China. chenzheyu@scu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 7, 2021; 27(41): 7173-7189 Published online Nov 7, 2021. doi: 10.3748/wjg.v27.i41.7173
Comprehensive radiomics nomogram for predicting survival of patients with combined hepatocellular carcinoma and cholangiocarcinoma
You-Yin Tang, Yu-Nuo Zhao, Tao Zhang, Zhe-Yu Chen, Xue-Lei Ma
You-Yin Tang, Zhe-Yu Chen, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Yu-Nuo Zhao, Xue-Lei Ma, Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, West China Hospital, Chengdu 610041, Sichuan Province, China
Tao Zhang, West China School of Medicine of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Tang YY and Zhao YN provided the study concept and designed this study; Tang YY acquired the data; Zhang T and Zhao YN carried out data analysis and interpretation; Tang YY and Zhang T were responsible for drafting and preliminarily revising the manuscript; Ma XL and Chen ZY performed study supervision and final approval.
Institutional review board statement: This retrospective study was approved by the West China Hospital Ethics Committee (Approval No. 2019903).
Conflict-of-interest statement: The authors declare that they have no competing interests as defined by Nature Research, or other interests that might be perceived to influence the results and/or discussion reported in this paper.
Data sharing statement: The clinical data and radiomics data were available from the corresponding author at Chenzheyu@scu.edu.cn. And no additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhe-Yu Chen, PhD, Chief Doctor, Full Professor, Postdoc, Surgeon, Surgical Oncologist, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, No. 37 Guoxue Street, Wuhou District, Chengdu 610041, Sichuan Province, China. chenzheyu@scu.edu.cn
Received: April 2, 2021 Peer-review started: April 2, 2021 First decision: June 24, 2021 Revised: June 26, 2021 Accepted: September 3, 2021 Article in press: September 3, 2021 Published online: November 7, 2021 Processing time: 217 Days and 13.6 Hours
ARTICLE HIGHLIGHTS
Research background
Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (cHCC-CCA) arises in hepatic progenitor cells and are defined as a single nodule showing differentiation into HCC and intrahepatic cholangiocarcinoma (ICC) with 5-year postoperative overall survival (OS) rates ranging from 8% to 63%. There are different opinions in the literature on whether the prognosis of patients with cHCC-CCA is worse than that of patients with simple HCC or similar ICC.
Research motivation
Due to the poor prognosis of cHCC-CCA and absence of a promising way to predict prognosis of cHCC-CCA, the authors aimed to construct a radiomics nomogram for predicting postoperative survival of cHCC-CCA patients. This prognostic model may help guide treatment decisions for these patients.
Research objectives
The purpose of this study was to construct and validate a nomogram based on radiomics and clinical characteristics to predict the postoperative survival rate of patients with cHCC-CCA.
Research methods
We collected the clinical data and computed tomography (CT) imaging data of patients with cHCC-CCA. Radiomics features were extracted from portal venous phase CT images using the least absolute shrinkage and selection operator Cox regression and random forest analysis. A nomogram integrating radiomics score and clinical factors was developed using multivariate Cox regression and each patient got a risk score. And patients were categorized as being at “high” or “low” risk based on their risk scores.
Research results
A total of five factors, which were Radiomics score, vascular invasion, anatomical resection, total bilirubin level, and satellite lesions, were independent predictors of prognosis and the nomogram was associated with OS more strongly than a model based on radiomics score or only clinical factors. Patients stratified as being at high risk showed a significantly shorter median OS than those stratified as being at low risk (6.1 vs 81.6 mo, P < 0.001).
Research conclusions
This nomogram have potential usefulness in predicting postoperative survival of cHCC-CCA patients and may therefore help identify those more likely to benefit from it, which may facilitate clinical decision-making.
Research perspectives
Considering the high AUC of this radiomics nomogram in predicting prognosis of cHCC-CCA, this prognostic model may help guide treatment decisions for these patients.
