Prognostic nomogram for hepatocellular carcinoma with radiofrequency ablation: a retrospective cohort study

Abstract

Background Radiofrequency ablation (RFA) is an effective treatment option for hepatocellular carcinoma (HCC). This study aimed to analyze the prognostic factors of HCC patients treated with RFA and to develop nomograms for outcome prediction. Methods A total of 3142 HCC patients treated with RFA were recruited, and their data were collected from the Surveillance, Epidemiology, and End Results database. Univariate and multifactor Cox analyses were performed to identify independent prognostic factors. These factors were integrated into a nomogram to predict 3- and 5-year cancer-specific survival (CSS) and overall survival (OS). Consistency indices and calibration plots were used to assess the accuracy of the nomograms in both the internal and external cohorts. Results The median follow-up periods for HCC patients treated with RFA were 27 and 29 months for OS and CSS, respectively. Marital status, age, race, histological grade of differentiation, tumor size, T stage, and serum alpha-fetoprotein levels at the time of diagnosis were identified as prognostic factors for OS and CSS. Additionally, M stage was identified as risk factors for OS. These risk factors are included in the nomogram. The calibration plots of the OS and CSS nomograms showed excellent consistency between actual survival and nomogram predictions. The bootstrap-corrected concordance indices of the OS and CSS nomograms were 0.637 (95% CI, 0.628–0.646) and 0.670 (95% 0.661–0.679), respectively. Importantly, our nomogram performed better discriminatory compared with 8th edition tumor-node-metastasis (TNM) stage system for predicting OS and CSS. Conclusions We identified prognostic factors for HCC patients treated with RFA and provided an accurate and personalized survival prediction scheme.

Development and Validation of a Nomogram to Predict Cancer-Specific Survival for Middle-Aged Patients With Early-Stage Hepatocellular Carcinoma

“…Social and demographic variables (age, race, and marital status) were identified as prognosticators of HCC. In our study, marital status is a relatively important factor for survival prediction, parallel to many previous studies ( 13 , 25 ). This is partly because most single, separated, and divorced cancer patients experience more stress and pain than married patients ( 26 ).…”

Magnetic Resonance Imaging Radiomics‐Based Nomogram From Primary Tumor for Pretreatment Prediction of Peripancreatic Lymph Node Metastasis in Pancreatic Ductal Adenocarcinoma: A Multicenter Study

“…A nomogram can be effectively used in the study of clinical events evaluation, which can accurately assess events, such as malignancy grades, metastasis, curative effect, survival time, and outcome, based on the clinicopathological characteristics of patients. [36][37][38][39] Compared with other types of predictive statistical models, the clearly visualized icon-based reproducible results can more directly estimate the probability of disease and provide an optimal prognostic risk assessment. In this study, The AUC of the external validation cohort was slightly lower than that of the training cohort in the Nonetheless, the AUC of the external validation cohort in the preoperative nomogram was greater than 0.7, which suggests that the combined preoperative nomogram has favorable discrimination ability and is a reliable tool for the clinical prediction of PLNM before treatment.…”

“…A nomogram can be effectively used in the study of clinical events evaluation, which can accurately assess events, such as malignancy grades, metastasis, curative effect, survival time, and outcome, based on the clinicopathological characteristics of patients 36–39 . Compared with other types of predictive statistical models, the clearly visualized icon‐based reproducible results can more directly estimate the probability of disease and provide an optimal prognostic risk assessment.…”

Development of a transformer model for predicting the prognosis of patients with hepatocellular carcinoma after radiofrequency ablation

“…The accurate prognosis prediction in HCC patients receiving RFA treatment was limited to fair to poor performance, with c-indices of 0.69 in the external validation site [ 24 ]. Lu et al developed a prognostic nomogram for predicting the overall survival of HCC patients after RFA, and showed a c -index of 0.637 in the internal verification using the bootstrap method [ 25 ]. Accurate estimation of the survival in HCC patients undergoing RFA remains a challenge due to the significant variability of the clinical outcomes, which could also be influenced by non-hepatic comorbidities.…”