A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma
Xia Du,1 Cheng-Nan Guo,2 Xiao-Dong Bao3 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou,...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-03-01
|
| Series: | Cancer Management and Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/a-powerful-nomogram-based-on-the-novel-d-index-to-predict-prognosis-af-peer-reviewed-article-CMAR |
| _version_ | 1831692445240262656 |
|---|---|
| author | Du X Guo CN Bao XD |
| author_facet | Du X Guo CN Bao XD |
| author_sort | Du X |
| collection | DOAJ |
| description | Xia Du,1 Cheng-Nan Guo,2 Xiao-Dong Bao3 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Central Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xiao-Dong BaoCentral Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325003, People’s Republic of ChinaTel +86 1 881 500 0923Email 512749893@qq.comPurpose: Conventional staging and scoring systems such as the Tumor, Node, and Metastasis; Cancer of the Liver Italian Program; Barcelona Clinic Liver Cancer; and Okuda have failed to predict overall survival (OS) in patients with resected primary hepatocellular carcinoma. Thus, we aimed to establish a novel D-index and nomogram to improve prognostic accuracy.Patients and Methods: We selected 396 patients who underwent liver resection between January 2007 and February 2015 at the First Affiliated Hospital of Wenzhou Medical University. These patients were randomly divided into the training and validation groups in a ratio of 7:3.Results: We generated a nomogram using five independent risk factors, including the D-index (calculated by total bilirubin × tumor size/the ratio of fat-to-muscle area 0.5) in the training set. The predictive performance of the nomogram was similar in both the training and validation cohorts according to the concordance index. The nomogram demonstrated the strongest predictive power for 1-year, 3-year, and 5-year OS, with the area under the receiving operating characteristic curve being 0.8486, 0.7785, and 0.752, respectively. The calibration curves exhibited stable capabilities in both cohorts. The stratification of the Kaplan-Meier curve was significant (P < 0.001).Conclusion: The associated nomogram of the D-index demonstrated a powerful and accurate predictive ability for OS in patients with primary hepatocellular carcinoma.Keywords: primary hepatocellular carcinoma, resection, D-index, nomogram, prognosis |
| first_indexed | 2024-12-20T11:53:43Z |
| format | Article |
| id | doaj.art-1c5c4c455ad94935b2fe70427319460d |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-20T11:53:43Z |
| publishDate | 2021-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-1c5c4c455ad94935b2fe70427319460d2022-12-21T19:41:42ZengDove Medical PressCancer Management and Research1179-13222021-03-01Volume 132581259463170A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular CarcinomaDu XGuo CNBao XDXia Du,1 Cheng-Nan Guo,2 Xiao-Dong Bao3 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Central Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xiao-Dong BaoCentral Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325003, People’s Republic of ChinaTel +86 1 881 500 0923Email 512749893@qq.comPurpose: Conventional staging and scoring systems such as the Tumor, Node, and Metastasis; Cancer of the Liver Italian Program; Barcelona Clinic Liver Cancer; and Okuda have failed to predict overall survival (OS) in patients with resected primary hepatocellular carcinoma. Thus, we aimed to establish a novel D-index and nomogram to improve prognostic accuracy.Patients and Methods: We selected 396 patients who underwent liver resection between January 2007 and February 2015 at the First Affiliated Hospital of Wenzhou Medical University. These patients were randomly divided into the training and validation groups in a ratio of 7:3.Results: We generated a nomogram using five independent risk factors, including the D-index (calculated by total bilirubin × tumor size/the ratio of fat-to-muscle area 0.5) in the training set. The predictive performance of the nomogram was similar in both the training and validation cohorts according to the concordance index. The nomogram demonstrated the strongest predictive power for 1-year, 3-year, and 5-year OS, with the area under the receiving operating characteristic curve being 0.8486, 0.7785, and 0.752, respectively. The calibration curves exhibited stable capabilities in both cohorts. The stratification of the Kaplan-Meier curve was significant (P < 0.001).Conclusion: The associated nomogram of the D-index demonstrated a powerful and accurate predictive ability for OS in patients with primary hepatocellular carcinoma.Keywords: primary hepatocellular carcinoma, resection, D-index, nomogram, prognosishttps://www.dovepress.com/a-powerful-nomogram-based-on-the-novel-d-index-to-predict-prognosis-af-peer-reviewed-article-CMARprimary hepatocellular carcinomaresectiond-indexnomogramprognosis |
| spellingShingle | Du X Guo CN Bao XD A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma Cancer Management and Research primary hepatocellular carcinoma resection d-index nomogram prognosis |
| title | A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma |
| title_full | A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma |
| title_fullStr | A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma |
| title_full_unstemmed | A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma |
| title_short | A Powerful Nomogram Based on the Novel D-Index to Predict Prognosis After Surgical Resection of Hepatocellular Carcinoma |
| title_sort | powerful nomogram based on the novel d index to predict prognosis after surgical resection of hepatocellular carcinoma |
| topic | primary hepatocellular carcinoma resection d-index nomogram prognosis |
| url | https://www.dovepress.com/a-powerful-nomogram-based-on-the-novel-d-index-to-predict-prognosis-af-peer-reviewed-article-CMAR |
| work_keys_str_mv | AT dux apowerfulnomogrambasedonthenoveldindextopredictprognosisaftersurgicalresectionofhepatocellularcarcinoma AT guocn apowerfulnomogrambasedonthenoveldindextopredictprognosisaftersurgicalresectionofhepatocellularcarcinoma AT baoxd apowerfulnomogrambasedonthenoveldindextopredictprognosisaftersurgicalresectionofhepatocellularcarcinoma AT dux powerfulnomogrambasedonthenoveldindextopredictprognosisaftersurgicalresectionofhepatocellularcarcinoma AT guocn powerfulnomogrambasedonthenoveldindextopredictprognosisaftersurgicalresectionofhepatocellularcarcinoma AT baoxd powerfulnomogrambasedonthenoveldindextopredictprognosisaftersurgicalresectionofhepatocellularcarcinoma |