Comprehensive evaluation of clinical outcomes in hepatic epithelioid hemangioendothelioma subsets: insights from SEER Database and departmental cohort analysis.

IF 5.7 2区 医学 Q1 IMMUNOLOGY
Frontiers in Immunology Pub Date : 2024-10-22 eCollection Date: 2024-01-01 DOI:10.3389/fimmu.2024.1491922
Bingchen Wang, Xiao Chen, Rongxuan Li, Bolun Ai, Feng Ye, Jianjun Zhao, Yefan Zhang, Zhen Huang, Zhiyu Li, Xinyu Bi, Hong Zhao, Dayong Cao, Jianqiang Cai, Jianguo Zhou, Tao Yan
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引用次数: 0

Abstract

Background: Epithelioid hemangioendothelioma (EHE), is an uncommon, intermediate-grade malignant vascular tumor that can manifest in diverse organs, including the liver, lungs, and bones. Given its unique malignancy profile and rarity, there lacks a consensus on a standardized treatment protocol for EHE, particularly for hepatic epithelioid hemangioendothelioma (HEHE). This study aims to elucidate factors influencing the clinical prognosis of EHE by analyzing data from the SEER database, complemented with insights from a departmental cohort of 9 HEHE cases. Through this, we hope to shed light on potential clinical outcomes and therapeutic strategies for HEHE.

Methods: Using SEER data from 22 registries, we analyzed 313 liver cancer patients with ICD-O-3 9130 and 9133 histology. Twelve variables were examined using Cox regression and mlr3 machine learning. Significant variables were identified and compared. Clinical data, imaging characteristics, and treatment methods of nine patients from our cohort were also presented.

Result: In univariate and multivariate Cox regression analyses, Age, Sex, Year of diagnosis, Surgery of primary site, Chemotherapy, and Median household income were closely related to survival outcomes. Among the ten survival-related machine learning models, CoxPH, Flexible, Mboost, and Gamboost stood out based on Area Under the Curve(AUC), Decision Curve Analysis(DCA), and Calibration Curve Metrics. In the feature importance analysis of these four selected models, Age and Surgery of primary site were consistently identified as the most critical factors influencing prognosis. Additionally, the clinical data of nine patients from our cohort not only demonstrated unique imaging characteristics of HEHE but also underscored the importance of surgical intervention.

Conclusion: For patients with resectable HEHE, surgical treatment is currently a highly important therapeutic approach.

全面评估肝上皮样血管内皮细胞瘤亚群的临床疗效:SEER数据库和部门队列分析的启示。
背景:上皮样血管内皮细胞瘤(EHE)是一种不常见的中级恶性血管肿瘤,可发生在肝脏、肺和骨骼等不同器官。鉴于其独特的恶性特征和罕见性,EHE,尤其是肝上皮样血管内皮细胞瘤(HEHE)的标准化治疗方案尚未达成共识。本研究旨在通过分析 SEER 数据库中的数据,并结合科室队列中的 9 例 HEHE 病例,阐明影响 EHE 临床预后的因素。我们希望借此揭示 HEHE 的潜在临床预后和治疗策略:利用来自 22 个登记处的 SEER 数据,我们分析了 313 例组织学为 ICD-O-3 9130 和 9133 的肝癌患者。我们使用 Cox 回归和 mlr3 机器学习对 12 个变量进行了研究。确定并比较了重要变量。此外,还介绍了队列中 9 名患者的临床数据、影像学特征和治疗方法:在单变量和多变量 Cox 回归分析中,年龄、性别、诊断年份、原发部位手术、化疗和家庭收入中位数与生存结果密切相关。根据曲线下面积(AUC)、决策曲线分析(DCA)和校准曲线指标,在十个与生存相关的机器学习模型中,CoxPH、Flexible、Mboost 和 Gamboost 脱颖而出。在对这四个选定模型进行的特征重要性分析中,年龄和原发部位手术被一致认定为影响预后的最关键因素。此外,我们队列中九名患者的临床数据不仅显示了 HEHE 独特的影像学特征,还强调了手术干预的重要性:结论:对于可切除的 HEHE 患者,手术治疗是目前非常重要的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.80
自引率
11.00%
发文量
7153
审稿时长
14 weeks
期刊介绍: Frontiers in Immunology is a leading journal in its field, publishing rigorously peer-reviewed research across basic, translational and clinical immunology. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Immunology is the official Journal of the International Union of Immunological Societies (IUIS). Encompassing the entire field of Immunology, this journal welcomes papers that investigate basic mechanisms of immune system development and function, with a particular emphasis given to the description of the clinical and immunological phenotype of human immune disorders, and on the definition of their molecular basis.
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