Jin-Long Huang1, Yi-Peng Fu1, Chu-Yu Jing1, Yong Yi1, Jian Sun1, Wei Gan1, Zhu-Feng Lu1, Jian Zhou1, Jia Fan1, Shuang-Jian Qiu1,2. 1. Liver Cancer Institute, Zhongshan Hospital and Shanghai Medical School, Fudan University, Key Laboratory for Carcinogenesis & Cancer Invasion, The Chinese Ministry of Education, Shanghai, People's Republic of China. 2. Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Abstract
BACKGROUND AND OBJECTIVES: Most conventional staging systems were formulated concerning the tumor burden rather than the severity of liver fibrosis, which plays a central role in tumor promotion. The aim of this study was to formulate a prognostic nomogram comprehensively considering these two aspects for HCC after hepatectomy. METHODS: The prognostic significances of the four indicators namely laminin, hyaluronic acid, human procollagen type-III, and collagen type-IV that reflect liver fibrosis were explored in two independent cohorts. A nomogram was established based on the results of multivariate analysis. The predictive accuracy of the nomogram was measured by concordance index (C-index) and calibration. The decision curve analysis (DCA) was used to evaluate the clinical benefit of the nomogram. RESULTS: Preoperative serum laminin level is an independent prognostic factor for overall survival in HCC patients after resection. The C-indices of the nomogram in the training and validation cohorts were 0.779 and 0.719, respectively. The calibration showed optimal agreement between the prediction by nomogram and actual observation. Moreover, the C-indices and DCA revealed that the nomogram provided better clinical benefit compared with the BCLC stage, CLIP score, and AJCC 7th edition. CONCLUSIONS: The prognostic nomogram constructed on laminin represents a superior predictive model.
BACKGROUND AND OBJECTIVES: Most conventional staging systems were formulated concerning the tumor burden rather than the severity of liver fibrosis, which plays a central role in tumor promotion. The aim of this study was to formulate a prognostic nomogram comprehensively considering these two aspects for HCC after hepatectomy. METHODS: The prognostic significances of the four indicators namely laminin, hyaluronic acid, human procollagen type-III, and collagen type-IV that reflect liver fibrosis were explored in two independent cohorts. A nomogram was established based on the results of multivariate analysis. The predictive accuracy of the nomogram was measured by concordance index (C-index) and calibration. The decision curve analysis (DCA) was used to evaluate the clinical benefit of the nomogram. RESULTS: Preoperative serum laminin level is an independent prognostic factor for overall survival in HCCpatients after resection. The C-indices of the nomogram in the training and validation cohorts were 0.779 and 0.719, respectively. The calibration showed optimal agreement between the prediction by nomogram and actual observation. Moreover, the C-indices and DCA revealed that the nomogram provided better clinical benefit compared with the BCLC stage, CLIP score, and AJCC 7th edition. CONCLUSIONS: The prognostic nomogram constructed on laminin represents a superior predictive model.
Authors: Xiaobo Wang; Zhaohui Zhang; Zhangqiang Wu; Yuezong Sun; Yili Zhang; Ming Gong; Feng Ji Journal: Zhejiang Da Xue Xue Bao Yi Xue Ban Date: 2020-05-25
Authors: Markus Bo Schoenberg; Julian Nikolaus Bucher; Dominik Koch; Nikolaus Börner; Sebastian Hesse; Enrico Narciso De Toni; Max Seidensticker; Martin Kurt Angele; Christoph Klein; Alexandr V Bazhin; Jens Werner; Markus Otto Guba Journal: Ann Transl Med Date: 2020-04