Development and validation of a clinicopathological‐based nomogram to predict seeding risk after percutaneous thermal ablation of primary liver carcinoma

Abstract

Objectives To develop a clinicopathological‐based nomogram to improve the prediction of the seeding risk of after percutaneous thermal ablation (PTA) in primary liver carcinoma (PLC). Methods A total of 2030 patients with PLC who underwent PTA were included between April 2009 and December 2018. The patients were grouped into a training dataset (n = 1024) and an external validation dataset (n = 1006). Baseline characteristics were collected to identify the risk factors of seeding after PTA. The multivariate Cox proportional hazards model based on the risk factors was used to develop the nomogram, which was used for assessment for its predictive accuracy using mainly the Harrell's C‐index and receiver operating characteristic curve (AUC). Results The median follow‐up time was 30.3 months (range, 3.2‐115.7 months). The seeding risk was 0.89% per tumor and 1.5% per patient in the training set. The nomogram was developed based on tumor size, subcapsular, α‐fetoprotein (AFP), and international normalized ratio (INR). The 1‐, 2‐, and 3‐year cumulative seeding rates were 0.1%, 0.7% and 1.2% in the low‐risk group, and 1.7%, 6.3% and 6.3% in the high‐risk group, respectively, showing significant statistical difference (P < .001). The nomogram had good calibration and discriminatory abilities in the training set, with C‐indexes of 0.722 (95% confidence interval [CI]: 0.661, 0.883) and AUC of 0.850 (95% CI: 0.767, 0.934). External validation with 1000 bootstrapped sample sets showed a good C‐index of 0.706 (95% CI: 0.546, 0.866) and AUC of 0.736 (95% CI: 0. 646, 0.827). Conclusions The clinicopathological‐based nomogram could be used to quantify the probability of seeding risk after PTA in PLC.

Microwave ablation versus laparoscopic resection as first‐line therapy for solitary 3–5‐cm HCC

“…Previous studies have documented that the size and location of HCC critically correlates with the possibility and difficulty of radical cure. [ 25 ] Although existing studies lead to inconsistent conclusions on the efficacy of LR and ablation for 3.1‐cm to 5.0‐cm HCC, more studies have shown that there are no differences in efficacy between the two treatments for 3.1‐cm to 4.0‐cm HCC, and the main bifurcations focused on the therapeutic efficacy of 4.1‐cm to 5.0‐cm HCC. Our stratified analyses determined that with advances in technology, the OS of MWA for 3.1‐cm to 4.0‐cm and 4.1‐cm to 5.0‐cm HCC was comparable to LLR, and DFS of MWA has solely achieved statistically significant improvement in the last 5 years.…”

“…[4] Although curable, single 3-5cm HCC belongs to the early stage, and the technical challenges and prognosis of treatment are strikingly different from those of small HCC. [25] Previous studies have explored the efficacy of LR and MWA in the treatment of 3-5-cm HCC, but no consensus conclusions have been reached. [8,9] The present multicenter, real-world study used a large sample size by PSM to directly compare two treatments for solitary 3-5-cm HCC, and aimed to provide evidence-based medicine for the minimally invasive treatment of HCC.…”

A nomogram model to predict the venous thromboembolism risk after surgery in patients with gynecological tumors

“…The nomogram is a useful and popular visual graph that illustrates the probability of occurrence of predicted events so as to guide clinical treatments [12][13][14]. Several past studies have reported that nomogram has good risk-prediction ability for post-surgical survival prognostication in patients with malignant tumors [15,16].…”