Development of a prognostic scoring model for predicting the survival of elderly patients with hepatocellular carcinoma
Development of a prognostic scoring model for predicting the survival of elderly patients with hepatocellular carcinoma
复制标题
DOI：
10.7717/peerj.8497
复制
发表时间：
2020-02-04
期刊：
影响因子：
2.7
通讯作者：
Zhu, Xuan
中科院分区：
文献类型：
--
作者：
Wan, Sizhe;Nie, Yuan;Zhu, Xuan
背景：老年肝细胞癌患者的数量正在增加，准确评估患者的预后是必要的。我们开发了一个预后评分模型来预测老年肝癌患者的生存。方法：我们从监测、流行病学和最终结果(SEER)数据库中提取了4076名65岁患者的数据，并将他们随机分为训练组和验证组。用COX回归分析筛选有意义的独立预后因素。结果：年龄、种族、美国癌症联合委员会、肿瘤分化程度、肿瘤大小、甲胎蛋白和肿瘤治疗是影响老年肝癌患者生存的独立预后因素。我们开发了一个基于这七个有意义的变量的预后评分模型来预测老年肝癌患者的生存。训练组和验证组模型的AUC分别为0.805(95%CI[0.788~0.821])和0.788(95%CI[0.759~0.816])。根据最佳分界值将患者分为低危组和高危组。Kaplan-Meier生存曲线显示，在训练组和验证组中，低风险组的存活率显著高于高风险组(P<；0.001)。结论：基于大人群，我们构建了一个预测老年肝癌患者生存的预后评分模型。该模型可为临床医生对老年肝癌患者的术前、术后评估提供参考。
Background: The number of elderly hepatocellular carcinoma (HCC) patients is increasing, and precisely assessing of the prognosis of these patients is necessary. We developed a prognostic scoring model to predict survival in elderly HCC patients.Methods: We extracted data from 4,076 patients >= 65 years old from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided them into training and validation groups. Cox regression analysis was used to screen for meaningful independent prognostic factors. The receiver operating characteristic curve reflected the model's discrimination power.Results: Age, race, American Joint Committee on Cancer stage, degree of tumour differentiation, tumour size, alpha-fetoprotein and tumour therapy were independent prognostic factors for survival in elderly HCC patients. We developed a prognostic scoring model based on the seven meaningful variables to predict survival in elderly HCC patients. The AUCs of the model were 0.805 (95% CI [0.788-0.821]) and 0.788 (95% CI [0.759-0.816]) in the training and validation groups, respectively. We divided the patients into low-risk groups and high-risk groups according to the optimal cut-off value. The Kaplan-Meier survival curve showed that in the training and validation groups, the survival rate of the low-risk group was significantly higher than that of the high-risk group (P < 0.001).Conclusion: Based on a large population, we constructed a prognostic scoring model for predicting survival in elderly HCC patients. The model may provide a reference for clinicians for preoperative and postoperative evaluations of elderly HCC patients.