Nankai University School of Medicine, Tianjin, China.
Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China.
J Surg Oncol. 2020 May;121(6):1007-1014. doi: 10.1002/jso.25859. Epub 2020 Jan 29.
This study aimed to assess the potential relationship between tumor mutation burden (TMB) and the recurrence risk of hepatocellular cancer (HCC) after curative resection and tried to develop a reliable TMB based nomogram.
This retrospective study was conducted in 128 patients (40 patients suffered from a recurrence of HCC) who had received radical hepatectomy by the same surgical team. A nomogram model was constructed using the R and EmpowerStats software.
TMB was not associated with maximum tumor size and the presence of microvascular invasion (MVI). In the whole population or subgroups, the recurrence-free survival (RFS) rate was significantly lower in the TMB high group. In multivariate analysis, TMB (hazard ratio [HR], 10.12; 95% confidence interval [CI], 5.03-20.31; P < .001), large tumor diameter (HR, 2.91; 95% CI, 1.51-5.63; P = .001), presence of MVI (HR, 1.93; 95% CI, 1.03-3.65; P = .042) were independent predictors of RFS. The predictive power of the nomogram integrating TMB, tumor size and MVI was higher than model only incorporating tumor size and MVI.
This study demonstrated for the first time that higher TMB was associated with poor prognosis in patients with HCC who had received curative resection, and a TMB based nomogram model had a well predictive performance for RFS in this population.
本研究旨在评估肿瘤突变负担（TMB）与根治性肝切除术后肝细胞癌（HCC）复发风险之间的潜在关系，并尝试建立一种可靠的基于 TMB 的列线图。
本回顾性研究纳入了 128 例（40 例 HCC 复发）接受同一手术团队根治性肝切除术的患者。使用 R 和 EmpowerStats 软件构建列线图模型。
TMB 与最大肿瘤直径和微血管侵犯（MVI）的存在无关。在全人群或亚组中，TMB 高组的无复发生存率（RFS）显著降低。多因素分析显示，TMB（风险比[HR]，10.12；95%置信区间[CI]，5.03-20.31；P < 0.001）、大肿瘤直径（HR，2.91；95% CI，1.51-5.63；P = 0.001）、MVI 的存在（HR，1.93；95% CI，1.03-3.65；P = 0.042）是 RFS 的独立预测因子。整合 TMB、肿瘤大小和 MVI 的列线图模型的预测能力高于仅纳入肿瘤大小和 MVI 的模型。
本研究首次表明，TMB 较高与接受根治性肝切除术后 HCC 患者的预后不良相关，基于 TMB 的列线图模型在该人群中对 RFS 具有良好的预测性能。
