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

Abstract

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.

• Authors: Jiang Jiang, Hao Hu, Rong Liu, Jian Hua Wang, Xiao Ran Long, Jia Fan, Zhi Ping Yan
• Journal: Medicine (Medicine (Baltimore)) Vol. 96 Issue 32 Pg. e7390 (Aug 2017) ISSN: 1536-5964 [Electronic] United States
• PMID: 28796032 (Publication Type: Journal Article, Observational Study)

Topics

• Adult
• Aged
• Carcinoma, Hepatocellular (etiology, pathology, surgery, therapy)
• Chemoembolization, Therapeutic (statistics & numerical data)
• Female
• Hepatitis B (complications)
• Humans
• Liver Neoplasms (etiology, pathology, surgery, therapy)
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Nomograms
• Retrospective Studies
• Risk Factors