A Nomogram for Preoperative Prediction of Vessels Encapsulating Tumor Clusters (VETC) Pattern and Prognosis of Hepatocellular Carcinoma

Abstract

BackgroundVessels encapsulating tumor clusters (VETC) pattern of hepatocellular carcinoma (HCC) are associated with unfavorable prognosis. This study aimed to establish a nomogram model to predict VETC patterns based on preoperative CT imaging features. Patients and MethodsPatients who underwent surgical resection between January 1, 2016 and August 31, 2022 were retrospectively included. Predictors associated with VETC pattern were determined by using logistic regression analyses, and a nomogram model was constructed. Prognostic factors associated with recurrence-free survival (RFS) after surgical resection were identified by using Cox regression analyses. ResultsA total of 84 patients were included for CT analysis. All patients underwent radical surgical resection. AST/ALT >1.07(odds ratio [OR], 4.91; 95% CI: 1.11, 21.68; P<0.05), intratumoral necrosis (OR, 4.99; 95% CI: 1.25, 19.99; P<0.05) and enhancing capsule (OR, 3.32; 95% CI: 1.27, 8.94; P<0.05) were independent predictors of VETC pattern. These features were used for the construction of nomogram model, which showed comparable prediction performance, with AUC value of 0.767 (95%CI [0.662, 0.852]). CK19 status (Hazard ratio [HR], 2.02; 95% CI: 1.06, 3.86; P<0.05), the number of tumors (HR, 3.31; 95% CI: 1.47, 7.45; P<0.05) and VETC pattern (HR, 2.52; 95% CI: 1.31, 4.86; P<0.05) were independent predictors of postoperative RFS. ConclusionA nomogram model based on preoperative CT imaging features could be used for the characterization of VETC pattern, and has prognostic significance for postoperative RFS in patients with HCC.