A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma
Abstract The nomogram of the Barcelona Clinic Liver Cancer (BCLC) has accurate outcome prediction. This study aims to propose a treatment-integrated nomogram derived from BCLC for patients with hepatocellular carcinoma (HCC). A total of 3,371 patients were randomly grouped into derivation (n = 2,247...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2017-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-017-08382-3 |
| _version_ | 1818425322349002752 |
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| author | Chia-Yang Hsu Po-Hong Liu Cheng-Yuan Hsia Yun-Hsuan Lee Teddy S. Nagaria Rheun-Chuan Lee Shu-Yein Ho Ming-Chih Hou Teh-Ia Huo |
| author_facet | Chia-Yang Hsu Po-Hong Liu Cheng-Yuan Hsia Yun-Hsuan Lee Teddy S. Nagaria Rheun-Chuan Lee Shu-Yein Ho Ming-Chih Hou Teh-Ia Huo |
| author_sort | Chia-Yang Hsu |
| collection | DOAJ |
| description | Abstract The nomogram of the Barcelona Clinic Liver Cancer (BCLC) has accurate outcome prediction. This study aims to propose a treatment-integrated nomogram derived from BCLC for patients with hepatocellular carcinoma (HCC). A total of 3,371 patients were randomly grouped into derivation (n = 2,247) and validation (n = 1,124) sets. Multivariate Cox proportional hazards model was used to generate the nomogram from tumor burden, cirrhosis, performance status (PS) and primary anti-cancer treatments. Concordance indices and calibration plots were used to evaluate the performance of nomogram. The derivation and validation sets had the same concordance index of 0.774 (95% confidence intervals: 0.717–0.826 and 0.656–0.874, respectively). In calibration plots, survival distributions predicted by the nomogram and observed by the Kaplan-Meier method were similar at 3- and 5-year for patients from derivation and validation sets. Validation group patients divided into 10 subgroups by the original and new treatment-integrated BCLC nomogram were used to evaluate the prognostic performance of integrating primary anti-cancer treatments. Compared to the nomogram of original BCLC system, the treatment-integrated nomogram of BCLC system had larger linear trend and likelihood ratio X2. In conclusion, based on the results of concordance index tests, integrating primary anti-cancer treatments into the BCLC system provides similar discriminatory ability. |
| first_indexed | 2024-12-14T14:12:06Z |
| format | Article |
| id | doaj.art-33e3881b6e8d44b9b638ccfbd025c112 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T14:12:06Z |
| publishDate | 2017-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-33e3881b6e8d44b9b638ccfbd025c1122022-12-21T22:58:16ZengNature PortfolioScientific Reports2045-23222017-08-017111010.1038/s41598-017-08382-3A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular CarcinomaChia-Yang Hsu0Po-Hong Liu1Cheng-Yuan Hsia2Yun-Hsuan Lee3Teddy S. Nagaria4Rheun-Chuan Lee5Shu-Yein Ho6Ming-Chih Hou7Teh-Ia Huo8Department of Medicine, Taipei Veterans General HospitalDepartment of Medicine, Taipei Veterans General HospitalDepartment of Surgery, Taipei Veterans General HospitalFaculty of Medicine, National Yang-Ming University School of MedicineDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Medical Sciences Building, 6th Floor, 1 King’s College CirDepartment of Radiology, Taipei Veterans General HospitalDepartment of Medicine, Taipei Veterans General HospitalDepartment of Medicine, Taipei Veterans General HospitalDepartment of Medicine, Taipei Veterans General HospitalAbstract The nomogram of the Barcelona Clinic Liver Cancer (BCLC) has accurate outcome prediction. This study aims to propose a treatment-integrated nomogram derived from BCLC for patients with hepatocellular carcinoma (HCC). A total of 3,371 patients were randomly grouped into derivation (n = 2,247) and validation (n = 1,124) sets. Multivariate Cox proportional hazards model was used to generate the nomogram from tumor burden, cirrhosis, performance status (PS) and primary anti-cancer treatments. Concordance indices and calibration plots were used to evaluate the performance of nomogram. The derivation and validation sets had the same concordance index of 0.774 (95% confidence intervals: 0.717–0.826 and 0.656–0.874, respectively). In calibration plots, survival distributions predicted by the nomogram and observed by the Kaplan-Meier method were similar at 3- and 5-year for patients from derivation and validation sets. Validation group patients divided into 10 subgroups by the original and new treatment-integrated BCLC nomogram were used to evaluate the prognostic performance of integrating primary anti-cancer treatments. Compared to the nomogram of original BCLC system, the treatment-integrated nomogram of BCLC system had larger linear trend and likelihood ratio X2. In conclusion, based on the results of concordance index tests, integrating primary anti-cancer treatments into the BCLC system provides similar discriminatory ability.https://doi.org/10.1038/s41598-017-08382-3 |
| spellingShingle | Chia-Yang Hsu Po-Hong Liu Cheng-Yuan Hsia Yun-Hsuan Lee Teddy S. Nagaria Rheun-Chuan Lee Shu-Yein Ho Ming-Chih Hou Teh-Ia Huo A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma Scientific Reports |
| title | A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma |
| title_full | A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma |
| title_fullStr | A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma |
| title_full_unstemmed | A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma |
| title_short | A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma |
| title_sort | new treatment integrated prognostic nomogram of the barcelona clinic liver cancer system for hepatocellular carcinoma |
| url | https://doi.org/10.1038/s41598-017-08382-3 |
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