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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1360936
This article is part of the Research Topic Advancing Patient-Centric Oncology: Non-Operative Management and Surgical De-Escalation in Cancer Care View all 9 articles

Development and validation of a digital biopsy model to predict microvascular invasion in Hepatocellular Carcinoma

Provisionally accepted
Emrullah Birgin Emrullah Birgin 1*Heiner Nebelung Heiner Nebelung 2,3Schaima Abdelhadi Schaima Abdelhadi 4Johann S. Rink Johann S. Rink 5Matthias F. Froelich Matthias F. Froelich 5Svetlana Hetjens Svetlana Hetjens 6Mohammad Rahbari Mohammad Rahbari 4Patrick S. Téoule Patrick S. Téoule 4Erik Rasbach Erik Rasbach 4Christoph Reissfelder Christoph Reissfelder 4Jürgen Weitz Jürgen Weitz 7Stefan O. Schoenberg Stefan O. Schoenberg 5Carina Riediger Carina Riediger 7Verena Plodeck Verena Plodeck 3Nuh N. Rahbari Nuh N. Rahbari 1
  • 1 Department of General and Visceral Surgery, University Hospital Ulm, Ulm, Germany
  • 2 Technical University Dresden, Dresden, Lower Saxony, Germany
  • 3 Department of Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
  • 4 Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Baden-Württemberg, Germany
  • 5 Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
  • 6 Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Mannheim, Germany
  • 7 Department of Visceral-, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden, Germany

The final, formatted version of the article will be published soon.

    Microvascular invasion is a major histopathological risk factor of postoperative recurrence in patients with hepatocellular carcinoma. This study aimed to develop and validate a digital biopsy model using imaging features to predict microvascular invasion before hepatectomy.A total of 217 consecutive patients who underwent hepatectomy for resectable hepatocellular carcinoma were enrolled at two tertiary-care reference centers. An imaging-based digital biopsy model was developed and internally validated using logistic regression analysis with adjustments for age, sex, etiology of disease, size and number of lesions.Three imaging features, i.e., non-smoothness of lesion margin (OR = 16.40), ill-defined pseudocapsula (OR = 4.93), and persistence of intratumoral internal artery (OR = 10.50), were independently associated with microvascular invasion and incorporated into a prediction model. A scoring system with 0 -3 points was established for the prediction model. Internal validation confirmed an excellent calibration of the model. A cutoff of 2 points indicates a high risk of microvascular invasion (area under the curve 0.87). The overall survival and recurrence-free survival stratified by the risk model was significantly shorter in patients with high risk features of microvascular invasion compared to those patients with low risk of microvascular invasion (overall survival: median 35 vs. 75 months, P = 0.027; recurrence-free survival: median 17 vs. 38 months, P < 0.001)).A preoperative assessment of microvascular invasion by digital biopsy is reliable, easily applicable, and might facilitate personalized treatment strategies.

    Keywords: biomarker1, radiology2, resection3, perioperative oncology4, hepatectomy5

    Received: 24 Dec 2023; Accepted: 30 Aug 2024.

    Copyright: © 2024 Birgin, Nebelung, Abdelhadi, Rink, Froelich, Hetjens, Rahbari, Téoule, Rasbach, Reissfelder, Weitz, Schoenberg, Riediger, Plodeck and Rahbari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Emrullah Birgin, Department of General and Visceral Surgery, University Hospital Ulm, Ulm, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.