A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma
| Autor: | Xiao-Dong Bao, Cheng-Nan Guo, Xia Du |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Surgical resection medicine.medical_specialty Resection Metastasis nomogram 03 medical and health sciences 0302 clinical medicine medicine resection Original Research D-index Tumor size business.industry Cancer primary hepatocellular carcinoma Nomogram medicine.disease 030104 developmental biology Oncology Cancer Management and Research 030220 oncology & carcinogenesis Hepatocellular carcinoma Radiology prognosis Liver cancer business |
| Zdroj: | Cancer Management and Research |
| ISSN: | 1179-1322 |
| Popis: | Xia Du,1 Cheng-Nan Guo,2 Xiao-Dong Bao3 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Central Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xiao-Dong BaoCentral Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325003, People’s Republic of ChinaTel +86 1 881 500 0923Email 512749893@qq.comPurpose: Conventional staging and scoring systems such as the Tumor, Node, and Metastasis; Cancer of the Liver Italian Program; Barcelona Clinic Liver Cancer; and Okuda have failed to predict overall survival (OS) in patients with resected primary hepatocellular carcinoma. Thus, we aimed to establish a novel D-index and nomogram to improve prognostic accuracy.Patients and Methods: We selected 396 patients who underwent liver resection between January 2007 and February 2015 at the First Affiliated Hospital of Wenzhou Medical University. These patients were randomly divided into the training and validation groups in a ratio of 7:3.Results: We generated a nomogram using five independent risk factors, including the D-index (calculated by total bilirubin × tumor size/the ratio of fat-to-muscle area 0.5) in the training set. The predictive performance of the nomogram was similar in both the training and validation cohorts according to the concordance index. The nomogram demonstrated the strongest predictive power for 1-year, 3-year, and 5-year OS, with the area under the receiving operating characteristic curve being 0.8486, 0.7785, and 0.752, respectively. The calibration curves exhibited stable capabilities in both cohorts. The stratification of the Kaplan-Meier curve was significant (P < 0.001).Conclusion: The associated nomogram of the D-index demonstrated a powerful and accurate predictive ability for OS in patients with primary hepatocellular carcinoma.Keywords: primary hepatocellular carcinoma, resection, D-index, nomogram, prognosis |
| Databáze: | OpenAIRE |
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