Development and validation of a novel nomogram predicting 10-year actual survival after curative hepatectomy for hepatocellular carcinoma.

Autor: Ng KKC; Department of Surgery, The Chinese University of Hong Kong, Hong Kong; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong. Electronic address: kkcng95@gmail.com., Cheng NMY; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Huang J; Department of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu, Sichuan, China., Liao M; Department of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China., Chong CCN; Department of Surgery, The Chinese University of Hong Kong, Hong Kong; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Lee KF; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Wong J; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Cheung SYS; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Lok HT; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Fung AKY; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong., Wong GLH; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Prince of Wales Hospital, New Territories, Hong Kong., Wong VWS; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Prince of Wales Hospital, New Territories, Hong Kong., Lai PBS; Department of Surgery, The Chinese University of Hong Kong, Hong Kong; Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong.
Jazyk: angličtina
Zdroj: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [Surgeon] 2021 Dec; Vol. 19 (6), pp. 329-337. Date of Electronic Publication: 2021 Jan 08.
DOI: 10.1016/j.surge.2020.11.013
Abstrakt: Introduction: Although hepatectomy is a curative treatment modality for hepatocellular carcinoma (HCC), the associated 10-year long-term actual survival are rarely reported. This study aims to develop and validate a predictive nomogram for 10-year actual survivors with HCC.
Materials and Methods: From 2004 to 2009, 753 patients with curative hepatectomy for HCC (development set, n = 325; validation set, n = 428) were included. In development set, comparison of clinic-pathological data was made between patients surviving ≥10 years and those surviving <10 years. Good independent prognostic factors identified by multivariate analysis were involved in a nomogram development, which was validated internally and externally using validation set.
Results: On multivariate analysis, five independent good prognostic factors for 10-year survival were identified, including young age (OR = 0.943), good ASA status (≤2) (OR = 2.794), higher albumin level (OR = 1.116), solitary tumor (OR = 2.531) and absence of microvascular invasion (OR = 3.367). A novel nomogram was constructed with C-index of 0.801 (95% CI 0.762-0.864). A cut-off point of 167.5 had a sensitivity of 0.794 and specificity of 0.730. Internal validation using bootstrap sampling and external validation using validation set revealed C-index of 0.792 (95% CI, 0.741-0.853) and 0.761 (95% CI, 0.718-0.817).
Conclusion: A novel nomogram for 10-year HCC survivor using age, ASA status, preoperative albumin, tumor number and presence of microvascular tumor invasion was developed and validated with high accuracy.
(Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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