Prognostic nomogram for patients with hepatocellular carcinoma underwent adjuvant transarterial chemoembolization following curative resection

Jing, Chuyu; Fu, Yi‐Peng; Zheng, Su-Su; Yi, Yong; Shen, Hujia; Ji, Huang; Xu, Xiaowu; Lin, Jiajia; Zhou, Jian; Fan, Jian‐Gao; Ren, Zhenggang; Qiu, Shuang–Jian; Zhang, Boheng

doi:10.1097/md.0000000000006140

Cited by 6 publications

(2 citation statements)

References 49 publications

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“…Recent studies have mainly focused on the inflammation index converted from multiple serum inflammatory indicators, such as the NLR, MLR, PLR, SII, and SIRI, modified Glasgow prognostic score (mGPS), and C-reactive protein/albumin ratio (CAR). Nomogram clinical models based on inflammatory indicators such as NLR, PLR, hypersensitive C-reactive protein (hs-CRP), and FC-score composed of fibrinogen and C-reactive protein are reported to have good predictive prognostic performances for HCC ( 7 , 17 – 19 ). In this study, several easily available inflammatory indicators were analyzed, including NLR, PLR, MLR, SIRI, and SII.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Based on Systemic Immune Inflammation Index and Prognostic Nutrition Index Predicts Recurrence of Hepatocellular Carcinoma After Surgery

et al. 2020

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Background Surgery is a potential cure for hepatocellular carcinoma (HCC), but its postoperative recurrence rate is high, its prognosis is poor, and reliable predictive indicators are lacking. This study was conducted to develop a simple, practical, and effective predictive model. Materials and Methods Preoperative clinical and postoperative pathological data on patients with HCC undergoing partial hepatectomies at the Third Affiliated Hospital of Soochow University from January 2010 to December 2015 were retrospectively analyzed, and a nomogram was constructed. The model performance was evaluated using C-indexes, receiver operating characteristic curves, and calibration curves. The results were verified from validation cohort data collected at the same center from January 2016 to January 2017 and compared with the traditional staging systems. Results Three hundred three patients were enrolled in this study: 238 in the training cohort and 65 in the validation cohort. From the univariate and multivariate Cox regression analyses in the training cohort, six independent risk factors, i.e., age, alpha-fetoprotein (AFP), tumor size, satellite nodules, systemic immune inflammation index (SII), and prognostic nutritional index (PNI), were filtered and included in the nomogram. The C-index was 0.701 [95% confidence interval (CI): 0.654–0.748] in the training cohort and 0.705 (95% CI: 0.619–0.791) in the validation cohort. The areas under the curve for the 1- and 3-year recurrence-free survival were 0.706 and 0.716 in the training cohort and 0.686 and 0.743 in the validation cohort, respectively. The calibration curves showed good agreement. Compared with traditional American Joint Committee on Cancer 8th edition (AJCC8th) and Barcelona Clinic Liver Cancer (BCLC) staging systems, our nomogram showed better predictive ability. Conclusion Our nomogram is simple, practical, and reliable. According to our nomogram, predicting the risk of recurrence and stratifying HCC patient management will yield the greatest survival benefit for patients.

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Section: Discussionmentioning

confidence: 99%

Nomogram Based on Systemic Immune Inflammation Index and Prognostic Nutrition Index Predicts Recurrence of Hepatocellular Carcinoma After Surgery

et al. 2020

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“…In the current study, we selected patients receiving R0 resection without p-TACE to establish a prediction model and then selected an external cohort including patients with or without p-TACE to verify whether the model could guide the application of p-TACE. Different from previous models [ 26 , 27 ], which selected patients receiving p-TACE to establish models directly, the methodology applied in this study had several advantages: 1) it decreased the interference of p-TACE because systematic reviews and meta-analyses failed to confirm a definite benefit of p-TACE [ 9 , 28 ]; and 2) it complied with the clinical treatment process completely because the surgical margin and postoperative pathology were the determinant factors of TACE.…”

Section: Discussionmentioning

confidence: 79%

A simplified model for prophylactic transarterial chemoembolization after resection for patients with hepatocellular carcinoma

Lin

Wang²,

Huang³

et al. 2022

PLoS ONE

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Background Prophylactic transarterial chemoembolization (p-TACE) is frequently conducted for patients with hepatocellular carcinoma (HCC) in China, but the question of who could benefit from it remains controversial. Hence, we wanted to establish a nomogram model to identify patients eligible for p-TACE. Methods Data from HCC patients receiving R0 resection with or without p-TACE between January 2013 and December 2014 were identified, using primary liver cancer big data, to establish a nomogram model to predict overall survival (OS). Based on the model, Patients receiving R0 resection between January 2015 and December 2015 were divided into three subgroups, and survival curves were constructed using the Kaplan–Meier method and analyzed by the log-rank test among patients in each subgroup. Results A nomogram integrating the neutrophil to lymphocyte ratio, AFP, tumor diameter, and microvascular invasion was developed to predict the OS of patients with HCC receiving R0 resection, and significant differences were observed in the median OS of the subgroups of low-risk (≤20), intermediate-risk (20~120), and high-risk (>120) identified by the current model. This model showed good calibration and discriminatory power in the validation cohort and the external cohort (c-index of 0.669 and 0.676, respectively). In the external cohort, the Kaplan–Meier curves showed that p-TACE could only significantly prolong the median OS of high-risk patients (25.6 vs. 33.7 months, P<0.05), but no differences were observed in any subgroups stratified by the current staging systems (all P>0.05). Conclusion This readily available nomogram model could help guide decisions about p-TACE, but it needs further validation.

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Prognostic Nomogram for Hepatitis B Virus–related Hepatocellular Carcinoma With Adjuvant Transarterial Chemoembolization After Radical Resection

Huang¹,

Liu²,

et al. 2019

American Journal of Clinical Oncology

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Objectives: The objective of this study was to establish a reliable and effective nomogram for predicting prognosis of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) with postoperative adjuvant transarterial chemoembolization (TACE). Patients and Methods: A derivation cohort of 370 HCC patients treated with postoperative TACE in the Eastern Hepatobiliary Surgery Hospital from January 2009 to December 2012 were retrospectively analyzed. Univariate and multivariate analysis were performed by Cox regression and independent prognostic factors for overall survival were determined to construct the nomogram. Concordance index (C-index), calibration curve and decision curve analysis were performed to evaluate the capability of the nomogram and the established nomogram was compared with TNM stage and Barcelona Clinic Liver Cancer (BCLC) stage to identify the superior model. The results were validated in a validation cohort of 123 HCC patients in the same center. Results: Multivariate analysis indicated that γ-glutamyl transferase, α-fetoprotein, tumor number, tumor size, satellite lesions, microvascular invasion, and HBV-DNA were independent prognostic factors for overall survival in the derivation cohort, and all these factors were selected into the nomogram. The C-index was 0.755 for survival prediction of the nomogram, which was significantly higher than the TNM stage (0.636, P<0.001) and BCLC stage (0.594, P<0.001). A fair uniformity and a superior net benefit with wide range threshold probabilities were showed in the calibration curves and decision curve analysis. In the validation cohort, the C-index of the nomogram (0.785) also had a higher predictive accuracy than TNM stage (0.744, P=0.019) and BCLC stage (0.616, P<0.001). Conclusions: The nomogram with accurate and reasonable performance was proposed for predicting survival of HBV-related HCC with postoperative adjuvant TACE.

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Prognostic nomogram for patients with hepatocellular carcinoma underwent adjuvant transarterial chemoembolization following curative resection

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 49 publications

Nomogram Based on Systemic Immune Inflammation Index and Prognostic Nutrition Index Predicts Recurrence of Hepatocellular Carcinoma After Surgery

Nomogram Based on Systemic Immune Inflammation Index and Prognostic Nutrition Index Predicts Recurrence of Hepatocellular Carcinoma After Surgery

A simplified model for prophylactic transarterial chemoembolization after resection for patients with hepatocellular carcinoma

Prognostic Nomogram for Hepatitis B Virus–related Hepatocellular Carcinoma With Adjuvant Transarterial Chemoembolization After Radical Resection

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