Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma
Zhi-Hao Zhao, Chao Jiang, Qing-Yuan Wu, Guo-Yue Lv, Meng Wang Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of ChinaCorrespondence: Meng Wang, Department of Hepatobiliary and Pancreatic...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-12-01
|
| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/nomogram-for-estimation-of-acute-liver-failure-risk-in-spontaneous-rup-peer-reviewed-fulltext-article-JHC |
| _version_ | 1797391187205685248 |
|---|---|
| author | Zhao ZH Jiang C Wu QY Lv GY Wang M |
| author_facet | Zhao ZH Jiang C Wu QY Lv GY Wang M |
| author_sort | Zhao ZH |
| collection | DOAJ |
| description | Zhi-Hao Zhao, Chao Jiang, Qing-Yuan Wu, Guo-Yue Lv, Meng Wang Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of ChinaCorrespondence: Meng Wang, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin Province, People’s Republic of China, Tel +86 13578767515, Email wmdoctor@jlu.edu.cnPurpose: Acute liver failure (ALF) is a severe complication of spontaneous ruptured hepatocellular carcinoma (SRHCC) that requires accurate prediction for effective treatment strategies. We aimed to develop a predictive nomogram to estimate the risk of ALF in patients with SRHCC undergoing treatment.Patients and Methods: We performed a retrospective analysis of historical data from 284 patients diagnosed with SRHCC at the First Hospital of Jilin University over the past decade. Variables were selected through univariate and multivariate logistic regression analyses, and a predictive nomogram was constructed. We evaluated its predictive accuracy against the Child-Pugh Score, R.MELD, and ALBI by assessing discrimination, calibration, and net clinical benefit.Results: Among the 284 patients, 65 developed ALF. The risk factors identified for model development included largest tumor size (LTS), platelet counts, prolonged prothrombin time, and elevated serum α-fetoprotein levels. The nomogram exhibited high accuracy in predicting ALF risk with a C-index of 0.91 (0.87– 0.95). The Delong test showed a significant difference between the nomogram and the other three models (p< 0.05). The calibration curve for the nomogram fit well, and the decision curve analysis revealed superior net benefit. The optimal cut-off point for the nomogram was determined to be 40, yielding sensitivity, specificity, positive predictive value, and negative predictive value of 83.10%, 87.20%, 65.90% and 94.60%, respectively.Conclusion: The nomogram we developed provides an optimized tool for predicting ALF in SRHCC patients. Its application can help determine individual patient’s risk of ALF, enabling more rational and personalized treatment strategies.Keywords: predict, transcatheter arterial chemoembolization, hepatectomy, prognosis, α-fetoprotein |
| first_indexed | 2024-03-08T23:28:14Z |
| format | Article |
| id | doaj.art-ee1a9554833c42038e6936a59cc33f3d |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-03-08T23:28:14Z |
| publishDate | 2023-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-ee1a9554833c42038e6936a59cc33f3d2023-12-14T17:01:45ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692023-12-01Volume 102223223788978Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular CarcinomaZhao ZHJiang CWu QYLv GYWang MZhi-Hao Zhao, Chao Jiang, Qing-Yuan Wu, Guo-Yue Lv, Meng Wang Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of ChinaCorrespondence: Meng Wang, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin Province, People’s Republic of China, Tel +86 13578767515, Email wmdoctor@jlu.edu.cnPurpose: Acute liver failure (ALF) is a severe complication of spontaneous ruptured hepatocellular carcinoma (SRHCC) that requires accurate prediction for effective treatment strategies. We aimed to develop a predictive nomogram to estimate the risk of ALF in patients with SRHCC undergoing treatment.Patients and Methods: We performed a retrospective analysis of historical data from 284 patients diagnosed with SRHCC at the First Hospital of Jilin University over the past decade. Variables were selected through univariate and multivariate logistic regression analyses, and a predictive nomogram was constructed. We evaluated its predictive accuracy against the Child-Pugh Score, R.MELD, and ALBI by assessing discrimination, calibration, and net clinical benefit.Results: Among the 284 patients, 65 developed ALF. The risk factors identified for model development included largest tumor size (LTS), platelet counts, prolonged prothrombin time, and elevated serum α-fetoprotein levels. The nomogram exhibited high accuracy in predicting ALF risk with a C-index of 0.91 (0.87– 0.95). The Delong test showed a significant difference between the nomogram and the other three models (p< 0.05). The calibration curve for the nomogram fit well, and the decision curve analysis revealed superior net benefit. The optimal cut-off point for the nomogram was determined to be 40, yielding sensitivity, specificity, positive predictive value, and negative predictive value of 83.10%, 87.20%, 65.90% and 94.60%, respectively.Conclusion: The nomogram we developed provides an optimized tool for predicting ALF in SRHCC patients. Its application can help determine individual patient’s risk of ALF, enabling more rational and personalized treatment strategies.Keywords: predict, transcatheter arterial chemoembolization, hepatectomy, prognosis, α-fetoproteinhttps://www.dovepress.com/nomogram-for-estimation-of-acute-liver-failure-risk-in-spontaneous-rup-peer-reviewed-fulltext-article-JHCpredicttranscatheter arterial chemoembolizationhepatectomyprognosisα-fetoprotein |
| spellingShingle | Zhao ZH Jiang C Wu QY Lv GY Wang M Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma Journal of Hepatocellular Carcinoma predict transcatheter arterial chemoembolization hepatectomy prognosis α-fetoprotein |
| title | Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma |
| title_full | Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma |
| title_fullStr | Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma |
| title_full_unstemmed | Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma |
| title_short | Nomogram for Estimation of Acute Liver Failure Risk in Spontaneous Ruptured Hepatocellular Carcinoma |
| title_sort | nomogram for estimation of acute liver failure risk in spontaneous ruptured hepatocellular carcinoma |
| topic | predict transcatheter arterial chemoembolization hepatectomy prognosis α-fetoprotein |
| url | https://www.dovepress.com/nomogram-for-estimation-of-acute-liver-failure-risk-in-spontaneous-rup-peer-reviewed-fulltext-article-JHC |
| work_keys_str_mv | AT zhaozh nomogramforestimationofacuteliverfailureriskinspontaneousrupturedhepatocellularcarcinoma AT jiangc nomogramforestimationofacuteliverfailureriskinspontaneousrupturedhepatocellularcarcinoma AT wuqy nomogramforestimationofacuteliverfailureriskinspontaneousrupturedhepatocellularcarcinoma AT lvgy nomogramforestimationofacuteliverfailureriskinspontaneousrupturedhepatocellularcarcinoma AT wangm nomogramforestimationofacuteliverfailureriskinspontaneousrupturedhepatocellularcarcinoma |