Surgical resection versus liver transplantation for hepatocellular carcinoma within the Hangzhou criteria: a preoperative nomogram-guided treatment strategy
Surgical resection versus liver transplantation for hepatocellular carcinoma within the Hangzhou criteria: a preoperative nomogram-guided treatment strategy
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符合杭州标准的肝细胞癌手术切除与肝移植：术前列线图指导的治疗策略
DOI：
10.1016/s1499-3872(17)60052-3
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发表时间：
2017-10-01
影响因子：
3.3
通讯作者：
Jiang, Nan
中科院分区：
文献类型：
--
作者：
Li, Yang;Ruan, Dan-Yun;Jiang, Nan
背景：随着手术标准的扩大，肝细胞癌手术切除（SR）与肝移植（LT）的疗效比较尚无定论。本研究旨在建立预测肝癌患者术后无复发生存的预后nomogram，并探讨nomogram作为治疗算法参考的可能性。方法：2003 - 2012年，310例符合杭州标准的肝癌患者行肝切除或肝移植手术。包括肿瘤总体积、白蛋白水平、HBV DNA拷贝数和门静脉高压症来构建nomogram。切除的患者按nomogram评分中位数116分分为低危组和高危组。确定独立危险因素，并采用Cox比例风险模型构建视觉定向nomogram预测SR患者的复发风险。结果：低危SR组预后优于高危SR组（3年无复发生存率，71.1%比35.9%；3年总生存率，89.8%比78.9%,P < 0.05）
BACKGROUND: With the expansion of surgical criteria, the comparative efficacy between surgical resection (SR) and liver transplantation (LT) for hepatocellular carcinoma is inconclusive. This study aimed to develop a prognostic nomogram for predicting recurrence-free survival of hepatocellular carcinoma patients after resection and explored the possibility of using nomogram as treatment algorithm reference.METHODS: From 2003 to 2012, 310 hepatocellular carcinoma patients within Hangzhou criteria undergoing resection or liver transplantation were included. Total tumor volume, albumin level, HBV DNA copies and portal hypertension were included for constructing the nomogram. The resection patients were stratified into low- and high-risk groups by the median nomogram score of 116. Independent risk factors were identified and a visually orientated nomogram was constructed using a Cox proportional hazards model to predict the recurrence risk for SR patients.RESULTS: The low-risk SR group had better outcomes compared with the high-risk SR group (3-year recurrence-free survival rate, 71.1% vs 35.9%; 3-year overall survival rate, 89.8% vs 78.9%, both P