Prognostic nomogram for post-surgical treatment with adjuvant TACE in hepatitis B virus-related hepatocellular carcinoma.
Prognostic nomogram for post-surgical treatment with adjuvant TACE in hepatitis B virus-related hepatocellular carcinoma.
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DOI：
10.18632/oncotarget.11078
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发表时间：
2016-09-06
期刊：
影响因子：
--
通讯作者：
Liu R
中科院分区：
文献类型：
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作者：
Hu H;Han XK;Long XR;Fan J;Yan ZP;Wang JH;Liu R
本研究旨在建立有效且可靠的预后列线图，以指导乙型肝炎病毒相关（HBV）肝细胞癌（HCC）患者术后辅助经动脉化疗栓塞（PA-TACE）的决策。推导组患者的 1、3、5 年总生存率分别为 87.7%、52.1% 和 28.3%，验证组患者的 1、3、5 年总生存率分别为 91.7%、57.1% 和 34.1%。多变量分析中的五个危险因素（HBV-DNA水平、血小板计数、血管侵犯、Child-Pugh评分变化和肿瘤直径）与预后显着相关。纳入这五个因素的统计列线图实现了良好的校准和区分能力，c 指数为 0.75（95% CI 0.67 至 0.83）。研究结果得到独立外部验证集的支持（c 指数，0.69；95% CI 0.56 至 0.83）。列线图评分低于 180 的患者被认为从 PA-TACE 中获得更高的生存获益。该列线图是根据对 2006 年至 2010 年在我们中心接受 PA-TACE 作为初始治疗的 235 名连续 HBV HCC 患者的回顾性研究获得的数据建立的。 2008 年 1 月至 2010 年 12 月期间在另一家机构收集的 84 名患者作为外部验证集。预后列线图是根据 PA-TACE 手术前获得的数据开发的。通过一致性指数（C 指数）、校准曲线和验证集评估列线图的预测准确性和判别能力。新的列线图可以实现 PA-TACE 在 HBV 相关 HCC 中的最佳预后预测。
This study sought to establish an effective and reliable prognostic nomogram to guide the decision for post-surgical adjuvant transarterial chemoembolization (PA-TACE) in patients with hepatitis B virus-related (HBV) hepatocellular carcinoma (HCC). The 1, 3, 5-year overall survival rates were, respectively, 87.7%, 52.1% and 28.3% in the patients from the derivation set and 91.7%, 57.1% and 34.1% in those from the validation set. Five risk factors (HBV-DNA level, platelet count, vascular invasion, change of Child-Pugh score, and tumor diameter) in the multivariate analysis were significantly associated with prognosis. The statistical nomogram incorporated these five factors achieved good calibration and discriminatory abilities with c-index of 0.75 (95% CI 0.67 to 0.83). The findings were supported by the independent external validation set (c-index, 0.69; 95% CI 0.56 to 0.83). Patients who had a nomogram score of less than 180 was considered to have higher survival benefit from PA-TACE. 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. 84 patients who were collected at another institution between 01/2008 and 12/2010 served as an external validation set. The prognostic nomogram 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 novel nomogram may achieve an optimal prognostic prediction for PA-TACE in HBV-related HCC.