Abstract |
Several models have been developed using conventional regression approaches to extend the criteria for liver transplantation (LT) in hepatocellular carcinoma (HCC) beyond the Milan criteria. We aimed to develop a novel model to predict tumor recurrence after LT by adopting artificial intelligence (MoRAL-AI). This study included 563 patients who underwent LT for HCC at three large LT centers in Korea. Derivation (n = 349) and validation (n = 214) cohorts were independently established. The primary outcome was time-to-recurrence after LT. A MoRAL-AI was derived from the derivation cohort with a residual block-based deep neural network. The median follow-up duration was 74.7 months (interquartile-range, 18.5-107.4); 204 patients (36.2%) had HCC beyond the Milan criteria. The optimal model consisted of seven layers including two residual blocks. In the validation cohort, the MoRAL-AI showed significantly better discrimination function (c-index = 0.75) than the Milan (c-index = 0.64), MoRAL (c-index = 0.69), University of California San Francisco (c-index = 0.62), up-to-seven (c-index = 0.50), and Kyoto (c-index = 0.50) criteria (all p < 0.001). The largest weighted parameter in the MoRAL-AI was tumor diameter, followed by alpha-fetoprotein, age, and protein induced by vitamin K absence-II. The MoRAL-AI had better predictability of tumor recurrence after LT than conventional models. The MoRAL-AI can also evolve with further data.
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Authors | Joon Yeul Nam, Jeong-Hoon Lee, Junho Bae, Young Chang, Yuri Cho, Dong Hyun Sinn, Bo Hyun Kim, Seoung Hoon Kim, Nam-Joon Yi, Kwang-Woong Lee, Jong Man Kim, Joong-Won Park, Yoon Jun Kim, Jung-Hwan Yoon, Jae-Won Joh, Kyung-Suk Suh |
Journal | Cancers
(Cancers (Basel))
Vol. 12
Issue 10
(Sep 29 2020)
ISSN: 2072-6694 [Print] Switzerland |
PMID | 33003306
(Publication Type: Journal Article)
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