Jong Man Kim1, Choon Hyuck David Kwon1, Jae-Won Joh2, Heejin Yoo3, Kyunga Kim3, Dong Hyun Sinn4, Gyu-Seong Choi1, Joon Hyeok Lee4. 1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. 2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. jw.joh@samsung.com. 3. Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Republic of Korea. 4. Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Several conventional staging systems use tumor count as a variable for tumor classification; however, most conventional staging systems for hepatocellular carcinoma (HCC) are not specifically constructed for surgically treated patients. The aim of this study was to create a prognostic nomogram based on patient' clinical and pathological features for predicting individual patient survival after liver resection as a primary therapy for solitary hepatitis B virus (HBV)-related HCC. METHODS: This study included patients who underwent curative liver resection for preoperative treatment-naïve HBV-related HCC between April 2007 and September 2014. All data were collected prospectively. RESULTS: A nomogram was generated for HCC recurrence and mortality in 420 hepatectomy patients. HCC recurrence was closely associated with the following factors: increased alkaline phosphatase, low albumin, increased protein induced by vitamin K absence/antagonism-II (PIVKA-II), multiple tumors, tumor hemorrhage, portal vein tumor thrombosis, intrahepatic metastasis, and free resection margin (< 4 cm). Increased alanine transaminase, tumor size ≥ 5 cm, and multiple tumors were predisposing factors for death. Nomograms using those factors had good calibration and discrimination abilities with C-indexes of 0.712 and 0.819, respectively. CONCLUSIONS: Our results suggest that prognostic nomograms in hepatectomy patients with HBV-related HCC can more precisely estimate postoperative survival of individual HBV-related HCC patients.
BACKGROUND: Several conventional staging systems use tumor count as a variable for tumor classification; however, most conventional staging systems for hepatocellular carcinoma (HCC) are not specifically constructed for surgically treated patients. The aim of this study was to create a prognostic nomogram based on patient' clinical and pathological features for predicting individual patient survival after liver resection as a primary therapy for solitary hepatitis B virus (HBV)-related HCC. METHODS: This study included patients who underwent curative liver resection for preoperative treatment-naïve HBV-related HCC between April 2007 and September 2014. All data were collected prospectively. RESULTS: A nomogram was generated for HCC recurrence and mortality in 420 hepatectomy patients. HCC recurrence was closely associated with the following factors: increased alkaline phosphatase, low albumin, increased protein induced by vitamin K absence/antagonism-II (PIVKA-II), multiple tumors, tumor hemorrhage, portal vein tumor thrombosis, intrahepatic metastasis, and free resection margin (< 4 cm). Increased alanine transaminase, tumor size ≥ 5 cm, and multiple tumors were predisposing factors for death. Nomograms using those factors had good calibration and discrimination abilities with C-indexes of 0.712 and 0.819, respectively. CONCLUSIONS: Our results suggest that prognostic nomograms in hepatectomy patients with HBV-related HCC can more precisely estimate postoperative survival of individual HBV-related HCC patients.
Authors: Jean-Nicolas Vauthey; Gregory Y Lauwers; Nestor F Esnaola; Kim-Anh Do; Jacques Belghiti; Nadeem Mirza; Steven A Curley; Lee M Ellis; Jean-Marc Regimbeau; Asif Rashid; Karen R Cleary; David M Nagorney Journal: J Clin Oncol Date: 2002-03-15 Impact factor: 44.544
Authors: Josep M Llovet; Adrian M Di Bisceglie; Jordi Bruix; Barnett S Kramer; Riccardo Lencioni; Andrew X Zhu; Morris Sherman; Myron Schwartz; Michael Lotze; Jayant Talwalkar; Gregory J Gores Journal: J Natl Cancer Inst Date: 2008-05-13 Impact factor: 13.506
Authors: Clifford S Cho; Mithat Gonen; Jinru Shia; Michael W Kattan; David S Klimstra; William R Jarnagin; Michael I D'Angelica; Leslie H Blumgart; Ronald P DeMatteo Journal: J Am Coll Surg Date: 2007-10-29 Impact factor: 6.113