A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy
Abstract Background Patients with hepatocellular carcinoma (HCC) undergoing surgical resection still have a high 5-year recurrence rate (~ 60%). With the development of laparoscopic hepatectomy (LH), few studies have compared the efficacy between LH and traditional surgical approach on HCC. The obje...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-10-01
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| Series: | Cancer Communications |
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| Online Access: | http://link.springer.com/article/10.1186/s40880-019-0404-6 |
| _version_ | 1818998412869107712 |
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| author | Yang-Xun Pan Jian-Cong Chen Ai-Ping Fang Xiao-Hui Wang Jin-Bin Chen Jun-Cheng Wang Wei He Yi-Zhen Fu Li Xu Min-Shan Chen Yao-Jun Zhang Qi-Jiong Li Zhong-Guo Zhou |
| author_facet | Yang-Xun Pan Jian-Cong Chen Ai-Ping Fang Xiao-Hui Wang Jin-Bin Chen Jun-Cheng Wang Wei He Yi-Zhen Fu Li Xu Min-Shan Chen Yao-Jun Zhang Qi-Jiong Li Zhong-Guo Zhou |
| author_sort | Yang-Xun Pan |
| collection | DOAJ |
| description | Abstract Background Patients with hepatocellular carcinoma (HCC) undergoing surgical resection still have a high 5-year recurrence rate (~ 60%). With the development of laparoscopic hepatectomy (LH), few studies have compared the efficacy between LH and traditional surgical approach on HCC. The objective of this study was to establish a nomogram to evaluate the risk of recurrence in HCC patients who underwent LH. Methods The clinical data of 432 patients, pathologically diagnosed with HCC, underwent LH as initial treatment and had surgical margin > 1 cm were collected. The significance of their clinicopathological features to recurrence-free survival (RFS) was assessed, based on which a nomogram was constructed using a training cohort (n = 324) and was internally validated using a temporal validation cohort (n = 108). Results Hepatitis B surface antigen (hazard ratio [HR], 1.838; P = 0.044), tumor number (HR, 1.774; P = 0.003), tumor thrombus (HR, 2.356; P = 0.003), cancer cell differentiation (HR, 0.745; P = 0.080), and microvascular tumor invasion (HR, 1.673; P =0.007) were found to be independent risk factors for RFS in the training cohort, and were used for constructing the nomogram. The C-index for RFS prediction in the training cohort using the nomogram was 0.786, which was higher than that of the 8th edition of the American Joint Committee on Cancer TNM classification (C-index, 0.698) and the Barcelona Clinic Liver Cancer staging system (C-index, 0.632). A high consistency between the nomogram prediction and actual observation was also demonstrated by a calibration curve. An improved predictive benefit in RFS and higher threshold probability of the nomogram were determined by receiver operating characteristic curve analysis, which was also confirmed in the validation cohort compared to other systems. Conclusions We constructed and validated a nomogram able to quantify the risk of recurrence after initial LH for HCC patients, which can be clinically implemented in assisting the planification of individual postoperative surveillance protocols. |
| first_indexed | 2024-12-20T22:01:07Z |
| format | Article |
| id | doaj.art-304738053b46447aa26ca4cd09e3e25e |
| institution | Directory Open Access Journal |
| issn | 2523-3548 |
| language | English |
| last_indexed | 2024-12-20T22:01:07Z |
| publishDate | 2019-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Communications |
| spelling | doaj.art-304738053b46447aa26ca4cd09e3e25e2022-12-21T19:25:21ZengWileyCancer Communications2523-35482019-10-0139111110.1186/s40880-019-0404-6A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomyYang-Xun Pan0Jian-Cong Chen1Ai-Ping Fang2Xiao-Hui Wang3Jin-Bin Chen4Jun-Cheng Wang5Wei He6Yi-Zhen Fu7Li Xu8Min-Shan Chen9Yao-Jun Zhang10Qi-Jiong Li11Zhong-Guo Zhou12State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Public Health, Sun Yat-sen UniversityState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterAbstract Background Patients with hepatocellular carcinoma (HCC) undergoing surgical resection still have a high 5-year recurrence rate (~ 60%). With the development of laparoscopic hepatectomy (LH), few studies have compared the efficacy between LH and traditional surgical approach on HCC. The objective of this study was to establish a nomogram to evaluate the risk of recurrence in HCC patients who underwent LH. Methods The clinical data of 432 patients, pathologically diagnosed with HCC, underwent LH as initial treatment and had surgical margin > 1 cm were collected. The significance of their clinicopathological features to recurrence-free survival (RFS) was assessed, based on which a nomogram was constructed using a training cohort (n = 324) and was internally validated using a temporal validation cohort (n = 108). Results Hepatitis B surface antigen (hazard ratio [HR], 1.838; P = 0.044), tumor number (HR, 1.774; P = 0.003), tumor thrombus (HR, 2.356; P = 0.003), cancer cell differentiation (HR, 0.745; P = 0.080), and microvascular tumor invasion (HR, 1.673; P =0.007) were found to be independent risk factors for RFS in the training cohort, and were used for constructing the nomogram. The C-index for RFS prediction in the training cohort using the nomogram was 0.786, which was higher than that of the 8th edition of the American Joint Committee on Cancer TNM classification (C-index, 0.698) and the Barcelona Clinic Liver Cancer staging system (C-index, 0.632). A high consistency between the nomogram prediction and actual observation was also demonstrated by a calibration curve. An improved predictive benefit in RFS and higher threshold probability of the nomogram were determined by receiver operating characteristic curve analysis, which was also confirmed in the validation cohort compared to other systems. Conclusions We constructed and validated a nomogram able to quantify the risk of recurrence after initial LH for HCC patients, which can be clinically implemented in assisting the planification of individual postoperative surveillance protocols.http://link.springer.com/article/10.1186/s40880-019-0404-6Hepatocellular carcinomaLaparoscopic hepatectomyRecurrenceNomogramAmerican Joint Committee on Cancer TNM classificationBarcelona Clinic Liver Cancer staging system |
| spellingShingle | Yang-Xun Pan Jian-Cong Chen Ai-Ping Fang Xiao-Hui Wang Jin-Bin Chen Jun-Cheng Wang Wei He Yi-Zhen Fu Li Xu Min-Shan Chen Yao-Jun Zhang Qi-Jiong Li Zhong-Guo Zhou A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy Cancer Communications Hepatocellular carcinoma Laparoscopic hepatectomy Recurrence Nomogram American Joint Committee on Cancer TNM classification Barcelona Clinic Liver Cancer staging system |
| title | A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy |
| title_full | A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy |
| title_fullStr | A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy |
| title_full_unstemmed | A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy |
| title_short | A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy |
| title_sort | nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy |
| topic | Hepatocellular carcinoma Laparoscopic hepatectomy Recurrence Nomogram American Joint Committee on Cancer TNM classification Barcelona Clinic Liver Cancer staging system |
| url | http://link.springer.com/article/10.1186/s40880-019-0404-6 |
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