Prognostic Nomograms for Patients with Hepatocellular Carcinoma After Curative Hepatectomy, with a Focus on Recurrence Timing and Post-Recurrence Management
Prognostic Nomograms for Patients with Hepatocellular Carcinoma After Curative Hepatectomy, with a Focus on Recurrence Timing and Post-Recurrence Management
Blog Article
Wei Xu,* Fei Liu,* Xianbo Shen,* Ruineng Li Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Hospital Affiliated with Hunan Normal University, Changsha, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei XuDepartment of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Hospital Affiliated with Hunan Normal University, Changsha, People’s Republic of ChinaTel +86 13873159491Fax +86 73182278012Email [email protected]: Prognoses of patients with hepatocellular wella color charm 050 cooling violet carcinoma (HCC) after curative hepatectomy remain unsatisfactory because of the high incidence of postoperative recurrence.Published predictive systems focus on pre-resection oncological characteristics, ignoring post-recurrence factors.
Purpose: This study aimed to develop prognostic nomograms for 3- and 5-year overall survival (OS) of patients with HCC after curative hepatectomy, focusing on potentially influential post-recurrence factors.Patients and Methods: Clinicopathological and postoperative follow-up data were extracted from 494 patients with HCC who underwent curative hepatectomy between January 2012 and June 2019.Early recurrence (ER) and late recurrence (LR) were defined as recurrence at ≤ 2 and > 2 years, respectively, after curative hepatectomy.
Nomograms for the prediction of 3- and 5-year OS were established based on multivariate analysis.The areas under time-dependent receiver operating characteristic curves (AUCs) for the nomograms were calculated independently to verify predictive accuracy.The nomograms were internally validated based on 2000 bootstrap resampling of 75% of the original data.
Results: In total, 494 patients with HCC who underwent curative hepatectomy met the eligibility criteria.Cox proportional hazard regression analysis identified factors potentially influencing 3- and 5-year OS.Multivariate analysis indicated that mcdsp apb 8 patient age, Hong Kong Liver Cancer stage, γ-glutamyl transferase (γ-GGT) level, METAVIR inflammation activity grade, ER and post-recurrence treatment modality were influencing factors for 3-year OS (AUC, 0.
891; 95% CI, 0.8364– 0.9447).
γ-GGT > 60 U/L, hepatectomy extent, LR and post-recurrence treatment modality were influencing factors for 5-year OS (AUC, 0.864; 95% CI, 0.8041– 0.
9237).Calibration plots showed satisfactory concordance between the predicted and actual observation cohorts.Conclusion: We propose new prognostic nomograms for OS prediction with a focus on the differentiation of recurrence timing and post-recurrence management.
These nomograms overcome the shortcomings of previous predictive nomograms and significantly improve predictive accuracy.Keywords: hepatocellular carcinoma, hepatectomy, post-recurrence management, overall survival, nomogram.