LI-RADS categories and clinicopathological features predict recurrence-free survival in patients with radical resected hepatocellular carcinoma.

[OBJECTIVE] To assess the value of LI-RADS categories and clinicopathological characteristics in predicting recurrence-free survival (RFS) after radical resection of hepatocellular carcinoma (HCC).

[MATERIALS AND METHODS] This retrospective study included HCC patients who underwent surgical resection between January 2014 and July 2018. Two radiologists independently evaluated the LI-RADS v2018 categories. Clinicopathological parameters were documented. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors for RFS. These risk factors were then used to constructe a nomogram, its performance was evaluated with receiver operating characteristic (ROC) curve analysis. Internal validation was performed via bootstrap resampling, with calibration curves and the C-index assessing model consistency.

[RESULTS] A total of 218 patients (mean age: 49.47 ± 11.14 years; 184 males) were included. Multivariate analysis revealed that tumor maximum diameter (hazard ratio (HR) = 1.01 [95 % confidence interval (CI): 1.01, 1.01], p < 0.001), tumor number (>1; HR = 1.95 [95 % CI: 1.39, 2.74], p < 0.001), LI-RADS category ((LR-TIV: HR = 2.01 [95 % CI: 1.33, 3.04], p < 0.001), and MVI grading (M2: HR = 2.70 [95 % CI: 1.70, 4.31], p < 0.001) were independent risk factors and were used to construct a nomogram. The areas under the ROC curves (AUCs) in predicting the 1-, 2-, and 5-year RFS rates were 0.84 (95 % CI: 0.79, 0.89), 0.77 (95 % CI: 0.71, 0.83) and 0.77 (95 % CI: 0.69, 0.84), respectively. The bootstrap-corrected C-index was 0.73 (95 % CI: 0.69, 0.77).

[CONCLUSION] The nomogram combining LI-RADS category, tumor maximum diameter and number, and MVI grading could provide a practical tool for post-resection RFS prediction in HCC patients.