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Nomogram for individualized prediction of recurrence after postoperative adjuvant TACE for hepatitis B virus-related hepatocellular carcinoma

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机构: [1]Fudan Univ, Shanghai Med Coll, Zhongshan Hosp, Dept Intervent Radiol, Shanghai, Peoples R China; [2]Sun Yat Sen Univ, Canc Ctr, Guangzhou, Guangdong, Peoples R China; [3]Fudan Univ, Shanghai Med Coll, Liver Canc Inst, Zhongshan Hosp, Shanghai, Peoples R China
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关键词: hepatocellular carcinoma nomogram recurrence TACE

摘要:
This study sought to develop an effective and reliable nomogram for predictions of recurrence for postoperative adjuvant transarterial chemoembolization (PA-TACE) in patients with hepatitis B virus-related (HBV) hepatocellular carcinoma (HCC). The nomogram was established based on data obtained from a retrospective study on 235 consecutive patients with HBV HCC who received PA-TACE as an initial therapy from 2006 to 2010 in our center. Eighty-four patients who were collected at another institution between 01/2008 and 12/2010 served as an external validation set. Recurrence-free survival (RFS) was collected. The nomogram for tumor recurrence was developed based on the data obtained before the PA-TACE procedure. Predictive accuracy and discriminative ability of the nomogram were assessed by concordance index (C-index), calibration curves, and validation set. The 1, 2, 3-year RFS rates were 55.5%, 27.0%, and 14.1%, respectively, in the patients from the derivation set and 60.7%, 33.2%, and 23.8% in those from the validation set. Four risk factors (HBV-DNA level, vascular invasion, change of Child-Pugh score, and tumor diameter) in the multivariate analysis were significantly associated with RFS. The statistical nomogram incorporated these 4 factors achieved good calibration and discriminatory abilities with the c-index of 0.74 (95% CI 0.66-0.82). The findings were supported by the independent external validation set (c-index, 0.70; 95% CI 0.58-0.83). The area under the receiver operating characteristic curve in our model was greater than those of conventional staging systems in the validation patients (corresponding c-indices, 0.56-0.64). The novel nomogram may achieve an optimal prediction for recurrence outcome in HBV-related HCC with PA-TACE.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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第一作者机构: [1]Fudan Univ, Shanghai Med Coll, Zhongshan Hosp, Dept Intervent Radiol, Shanghai, Peoples R China;
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通讯机构: [1]Fudan Univ, Shanghai Med Coll, Zhongshan Hosp, Dept Intervent Radiol, Shanghai, Peoples R China;
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