Prognostic nomogram for hepatocellular carcinoma patients after transarterial chemoembolization based on des-γ-carboxy prothrombin reactivity and modified Response Evaluation Criteria in Solid Tumors.

Autor: Zhao SM; Department of Interventional Radiology, The First Affiliated Hospital of Soochow University; Department of InterventionalRadiology, Affiliated Hospital of Nantong University, Jiangsu, China., Qiu LW; Research Centre of Clinical Medicine, Affiliated Hospital of Nantong University, Jiangsu, China., Zhao H; Department of Interventional Radiology, Affiliated Hospital of Nantong University, Jiangsu, China., Gu WW; Department of Interventional Radiology, Affiliated Hospital of Nantong University, Jiangsu, China., Yang XH; Department of Interventional Radiology, Affiliated Hospital of Nantong University, Jiangsu, China., Gu ZX; Department of Interventional Radiology, Affiliated Hospital of Nantong University, Jiangsu, China., Shi RF; Department of Interventional Radiology, Affiliated Hospital of Nantong University, Jiangsu, China., Ni CF; Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Jiangsu, China.
Jazyk: angličtina
Zdroj: Journal of cancer research and therapeutics [J Cancer Res Ther] 2021 Jul; Vol. 17 (3), pp. 707-714.
DOI: 10.4103/jcrt.JCRT_651_20
Abstrakt: Aims: The aim of this study was to construct a nomogram that will predict the overall survival (OS) of hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE).
Materials and Methods: Imaging data, clinical characteristics, and serum des-γ-carboxy prothrombin (DCP) levels of 93 HCC patients treated with TACE were collected. Lasso regression, random forest, and other methods were used to screen the OS-related variables and construct the Cox prognosis model. The model was visualized by nomogram, and the net benefit of the clinical decision was assessed by decision curve analysis (DCA).
Results: It was found that DCP level after TACE was an important predictor of OS in HCC patients. The OS of the patients with lower serum DCP levels after TACE was significantly better than the group with higher levels (P = 0.003). The Cox prognostic model was constructed using four predictors including DCP reactivity (P = 0.001), modified Response Evaluation Criteria in Solid Tumors (mRECIST, P = 0.005), Child-Pugh class (P = 0.018), and portal vein thrombosis (P = 0.039). The C-index of the nomogram for OS of patients after TACE was 0.813. The clinical decision-making net benefits based on the nomogram were better than the decision-making based on the TNM stage system.
Conclusion: DCP reactivity and mRECIST are the key predictors of prognosis in HCC patients that received TACE as their initial treatment. The nomogram constructed with these two indicators as the core could predict the OS of HCC patients after TACE and help in clinical decision-making.
Competing Interests: None
Databáze: MEDLINE
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