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World J Gastrointest Surg. May 27, 2026; 18(5): 116135
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.116135
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.116135
Establishment and validation of an intratumoral fibrosis-based nomogram for predicting aggressive recurrence after liver resection in hepatocellular carcinoma
Qi-Yuan Deng, Hao-Qun Leng, Tian-Cheng Wang, Chao Hu, Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
Co-first authors: Qi-Yuan Deng and Hao-Qun Leng.
Author contributions: Deng QY and Leng HQ wrote the manuscript, reviewed and analyzed the patients’ clinical data and contributed equally to this article as co-first authors of this manuscript; Deng QY and Wang TC reviewed the histological slides; Deng QY, Leng HQ, and Wang TC collected and provided the patients’ clinical information; Hu C edited and revised the manuscript; Hu C was the main contributor and is the guarantor of this work; All authors read and approved the final manuscript.
Supported by the Hunan Provincial Natural Science Youth Fund Project, No. 2023JJ40824.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Second Xiangya Hospital of Central South University, approval No. Z0633-01.
Informed consent statement: The informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The patient-derived datasets generated during this study are not publicly available due to patient privacy restrictions but are accessible from the corresponding author upon reasonable request. The underlying code for this study is available in a public GitHub repository (https://github.com).
Corresponding author: Chao Hu, Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. huchao0101@csu.edu.cn
Received: November 4, 2025
Revised: January 10, 2026
Accepted: March 4, 2026
Published online: May 27, 2026
Processing time: 205 Days and 6.3 Hours
Revised: January 10, 2026
Accepted: March 4, 2026
Published online: May 27, 2026
Processing time: 205 Days and 6.3 Hours
Core Tip
Core Tip: Accurate risk stratification for aggressive recurrence is essential in patients with hepatocellular carcinoma undergoing liver resection. In this multicenter study we identified intratumoral fibrosis as a novel independent histopathological predictor of aggressive recurrence. We developed a competing risk nomogram by integrating intratumoral fibrosis with key clinical variables to provide individualized risk estimation. The model demonstrated robust performance across independent cohorts, offering a validated tool for improved postoperative prognostic stratification.