Predictors of one-year adverse outcomes after laparoscopic resection for hepatocellular carcinoma: Development and validation of an early-warning model

Table 1 Baseline data comparison (training vs validation groups)

Variable	Training group (n = 277)	Validation group (n = 144)	External validation group (n = 138)	Statistical values	P value
Sex
Male	182	96	91	0.040	0.980
Female	95	48	47
History of smoking
Yes	136	78	67	1.190	0.552
No	141	66	71
History of alcohol consumption
Yes	130	65	62	0.204	0.903
No	147	79	76
History of hypertension
Yes	89	54	47	1.218	0.544
No	188	90	91
History of diabetes
Yes	33	16	16	0.060	0.971
No	244	128	122
Hepatitis B
Yes	193	106	89	2.778	0.249
No	84	38	49
Child-Pugh classification
A	170	92	85	0.273	0.872
B	107	52	53
Tumor diameter
≥ 5 cm	120	55	54	1.285	0.526
< 5 cm	157	89	84
Tumor number
Single	221	111	112	0.759	0.684
Multiple	56	33	26
Degree of differentiation
Poorly differentiated	36	20	20	0.190	0.909
Moderately or well differentiated	241	124	118
Vascular invasion
Yes	66	30	35	0.853	0.653
No	211	114	103
Hepatic vein infiltration
Yes	18	11	8	0.400	0.819
No	259	133	130
Portal vein infiltration
Yes	37	20	18	0.045	0.978
No	240	124	120
Cirrhosis
Yes	165	80	79	0.664	0.717
No	112	64	59
AFP
≥ 400 μg/L	75	45	37	0.965	0.617
< 400 μg/L	202	99	101
WBC (× 109/L)	6.62 ± 1.28	6.74 ± 1.24	6.55 ± 1.33	0.844	0.431
PLT (× 109/L)	137.67 ± 24.72	138.74 ± 23.50	138.56 ± 22.91	0.119	0.888
ALB (g/L)	39.03 ± 7.66	39.74 ± 7.73	38.90 ± 7.83	0.520	0.595
ALT (U/L)	95.23 ± 17.37	95.34 ± 16.35	92.87 ± 17.04	1.037	0.355
AST (U/L)	100.87 ± 18.07	100.05 ± 17.43	100.62 ± 17.58	0.100	0.905
TBIL (μmol/L)	19.42 (16.69, 21.34)	19.41 (16.59, 22.29)	19.16 (15.97, 21.18)	0.873	0.646

WBC: White blood cell; AFP: Alpha-fetoprotein; PLT: Platelet count; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin.

Table 2 Baseline data comparison (good vs poor prognosis groups in the training group)

Variable	Poor prognosis group (n = 67)	Good prognosis group (n = 210)	Statistical values	P value
Sex
Male	46	136	0.342	0.559
Female	21	74
History of smoking
Yes	30	106	0.660	0.416
No	37	104
History of alcohol consumption
Yes	32	98	0.024	0.876
No	35	112
History of hypertension
Yes	21	68	0.025	0.874
No	46	142
History of diabetes
Yes	10	23	0.764	0.382
No	57	187
Hepatitis B
Yes	46	147	0.043	0.835
No	21	63
Child-Pugh classification
A	41	129	0.001	0.973
B	26	81
Tumor diameter
≥ 5 cm	37	83	5.099	0.024
< 5 cm	30	127
Tumor number
Single	48	173	3.632	0.057
Multiple	19	37
Degree of differentiation
Poorly differentiated	13	23	3.208	0.073
Moderately or well differentiated	54	187
Vascular invasion
Yes	23	43	5.370	0.020
No	44	167
Hepatic vein infiltration
Yes	6	12	0.878	0.349
No	61	198
Portal vein infiltration
Yes	15	22	6.228	0.013
No	52	188
Cirrhosis
Yes	47	118	4.109	0.043
No	20	92
AFP
≥ 400 μg/L	33	42	22.015	< 0.001
< 400 μg/L	34	168
WBC (× 109/L)	6.96 ± 1.25	6.51 ± 1.27	2.583	0.011
PLT (× 109/L)	141.88 ± 25.84	136.32 ± 24.27	1.555	0.123
ALB (g/L)	38.28 ± 8.21	39.27 ± 7.48	-0.886	0.378
ALT (U/L)	96.51 ± 17.76	94.83 ± 17.27	0.679	0.499
AST (U/L)	100.42 ± 18.82	101.01 ± 17.87	-0.224	0.823
TBIL (μmol/L)	19.39 ± 3.73	19.22 ± 3.61	0.33	0.742

AFP: Alpha-fetoprotein; WBC: White blood cell count; PLT: Platelet count; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin.

Table 3 Receiver operating characteristic curve parameters of the training and validation groups

Marker	AUC	95%CI	Specificity, %	Sensitivity, %	Youden index, %	Cut off	Accuracy, %	Precision	F1 score, %
LASSO risk score (training group)	0.756	0.687-0.824	67.62	74.63	42.25	-1.256	69.31	74.63	54.05
LASSO risk score (validation group)	0.75	0.659-0.841	54.95	84.85	39.80	-1.604	61.81	84.85	50.45

LASSO: Least absolute shrinkage and selection operator; AUC: Area under the curve; CI: Confidence interval.

Table 4 Calculation of patient score

Variable	Patient 1	Patient 2
WBC (× 109/L)	9.52	5.5
Tumor diameter	< 5 cm	≥ 5 cm
Vascular invasion	Yes	No
Portal vein infiltration	Yes	No
Cirrhosis	Yes	Yes
AFP	≥ 400 μg/L	< 400 μg/L
Total score	418	268
Probability of poor prognosis	100%	32.5%

WBC: White blood cell; AFP: Alpha-fetoprotein.