Zhenhua Lu1,2, Zhen Sun1,3, Chengyu Liu1,2, Xiaolei Shi1, Rui Li1,3, Weiwei Shao1, Yangyang Zheng1, Yao Li1, Jinghai Song4,5. 1. Department of General Surgery, Department of Hepato-bilio-pancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO. 1 DaHua Road, Dong Dan, Beijing, 100730, PR China. 2. The Key Laboratory of geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China. 3. Peking University Fifth School of Clinical Medicine, Beijing, 100730, China. 4. Department of General Surgery, Department of Hepato-bilio-pancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO. 1 DaHua Road, Dong Dan, Beijing, 100730, PR China. jhaisong2003@163.com. 5. The Key Laboratory of geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China. jhaisong2003@163.com.
Abstract
BACKGROUND: Radiofrequency ablation (RFA) is an effective treatment option for hepatocellular carcinoma (HCC). This study aimed to analyze the prognostic factors of HCC patients treated with RFA and to develop nomograms for outcome prediction. METHODS: A total of 3142 HCC patients treated with RFA were recruited, and their data were collected from the Surveillance, Epidemiology, and End Results database. Univariate and multifactor Cox analyses were performed to identify independent prognostic factors. These factors were integrated into a nomogram to predict 3- and 5-year cancer-specific survival (CSS) and overall survival (OS). Consistency indices and calibration plots were used to assess the accuracy of the nomograms in both the internal and external cohorts. RESULTS: The median follow-up periods for HCC patients treated with RFA were 27 and 29 months for OS and CSS, respectively. Marital status, age, race, histological grade of differentiation, tumor size, T stage, and serum alpha-fetoprotein levels at the time of diagnosis were identified as prognostic factors for OS and CSS. Additionally, M stage was identified as risk factors for OS. These risk factors are included in the nomogram. The calibration plots of the OS and CSS nomograms showed excellent consistency between actual survival and nomogram predictions. The bootstrap-corrected concordance indices of the OS and CSS nomograms were 0.637 (95% CI, 0.628-0.646) and 0.670 (95% 0.661-0.679), respectively. Importantly, our nomogram performed better discriminatory compared with 8th edition tumor-node-metastasis (TNM) stage system for predicting OS and CSS. CONCLUSIONS: We identified prognostic factors for HCC patients treated with RFA and provided an accurate and personalized survival prediction scheme.
BACKGROUND: Radiofrequency ablation (RFA) is an effective treatment option for hepatocellular carcinoma (HCC). This study aimed to analyze the prognostic factors of HCCpatients treated with RFA and to develop nomograms for outcome prediction. METHODS: A total of 3142 HCCpatients treated with RFA were recruited, and their data were collected from the Surveillance, Epidemiology, and End Results database. Univariate and multifactor Cox analyses were performed to identify independent prognostic factors. These factors were integrated into a nomogram to predict 3- and 5-year cancer-specific survival (CSS) and overall survival (OS). Consistency indices and calibration plots were used to assess the accuracy of the nomograms in both the internal and external cohorts. RESULTS: The median follow-up periods for HCCpatients treated with RFA were 27 and 29 months for OS and CSS, respectively. Marital status, age, race, histological grade of differentiation, tumor size, T stage, and serum alpha-fetoprotein levels at the time of diagnosis were identified as prognostic factors for OS and CSS. Additionally, M stage was identified as risk factors for OS. These risk factors are included in the nomogram. The calibration plots of the OS and CSS nomograms showed excellent consistency between actual survival and nomogram predictions. The bootstrap-corrected concordance indices of the OS and CSS nomograms were 0.637 (95% CI, 0.628-0.646) and 0.670 (95% 0.661-0.679), respectively. Importantly, our nomogram performed better discriminatory compared with 8th edition tumor-node-metastasis (TNM) stage system for predicting OS and CSS. CONCLUSIONS: We identified prognostic factors for HCCpatients treated with RFA and provided an accurate and personalized survival prediction scheme.
Authors: Mahul B Amin; Frederick L Greene; Stephen B Edge; Carolyn C Compton; Jeffrey E Gershenwald; Robert K Brookland; Laura Meyer; Donna M Gress; David R Byrd; David P Winchester Journal: CA Cancer J Clin Date: 2017-01-17 Impact factor: 508.702
Authors: Samer Tohme; David A Geller; Jon S Cardinal; Hui-Wei Chen; Vignesh Packiam; Srinevas Reddy; Jennifer Steel; James W Marsh; Allan Tsung Journal: HPB (Oxford) Date: 2012-08-12 Impact factor: 3.647