A nomogram predicting the recurrence-free survival of hepatocellular carcinoma patients after liver resection
Objective To develop a nomogram to predict postoperative recurrence-free survival(RFS)of hepatocellular carcinoma(HCC)patients,and to further stratify the prognosis to guide postoperative adjuvant transarterial chemoembolization therapy.Methods The clinicopathological data of 578 HCC patients who underwent liver resection were analyzed.Survival curves were calculated using the Kaplan-Meier method and compared using the Log-rank test.Independent risk factors associated with RFS were identified by Cox proportional hazard model and used to conduct prognostic nomogram.Results Among all patients,the median RFS was 29.6 months(95％CI:22.8-36.5 months),with 1,3,and 5-year recurrence-free survival rates of 68.7％,46.4％and 36.2％,respectively.Multivariate analysis showed that HBV-DNA(HR=1.307,95％CI:1.063-1.606),prothrombin time(HR=1.122,95％CI:1.008-1.249),neutrophil to lymphocyte ratio(HR=1.046,95％CI:1.003-1.091),tumor diameter(HR=1.084,95％CI:1.048-1.121),multiple tumors(HR=1.365,95％CI:1.008-1.849),presence of satellite nodules(HR=1.717,95％CI:1.284-2.297)and microvascular invasion(HR=1.420,95％CI:1.144-1.763)were the independent prognostic factors associated with RFS(P＜0.05).The consistency index of the nomogram was 0.664(95％CI:0.636-0.693),and the calibration curve showed good consistency between the predicted and actual results.This nomogram could effectively classify patients into good,middle,and poor groups.The recurrence-free survival rates and overall survival rates of patients in the poor group were significantly lower than those in the other two groups.Among patients in the poor group,postoperative adjuvant transarterial chemoembolization could improve prognosis.Conclusion This study established a nomogram using the clinicopathological characteristics of HCC patients,which can be used to predict postoperative RFS and guide postoperative adjuvant therapy.
万方数据
维普
