Prognostic Nomogram for Patients with Hepatocellular Carcinoma After Thermal Ablation
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CLINICAL INVESTIGATION
INTERVENTIIONAL ONCOLOGY
Prognostic Nomogram for Patients with Hepatocellular Carcinoma After Thermal Ablation Min Ding1 • Xiaodong Zhao2 • Mingchen Zhao3 • Yaoping Shi1 • Tao Wang1 Dan Cui1 • Donghua Shi1 • Bo Zhai1
•
Received: 13 March 2020 / Accepted: 2 August 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To develop an effective prognostic nomogram for patients with hepatocellular carcinoma (HCC) after thermal ablation. Methods A total of 772 patients with intrahepatic primary or recurrent HCC who underwent radiofrequency ablation or microwave ablation between March 2011 and October 2016 were included. 602 patients (mean age, 56.0 ± 11.9 years; 495 male/107 female) were included in the primary cohort to establish a prognostic nomogram. Significant prognostic factors for overall survival (OS) identified by Cox univariate and multivariate regression analyses were used to construct the nomogram. The remaining 170 patients (mean age, 55.9 ± 11.9 years; 145 male/25 female) were used to validate the predictive accuracy of the nomogram. Results During a mean follow-up period of 26 months (range 1–85 months), the median OS periods were 48.6 months and 44.0 months for the primary and validation cohorts. The 1-, 3-, and 5-year OS rates were 85.5%, 61.4%, and 43.3% in the primary cohort and 84.7%, 59.6%,
Min Ding and Xiaodong Zhao have contributed equally to this work and should be considered co-first authors. & Bo Zhai [email protected] 1
Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao-tong University, No. 160, Pujian Road, Pudong New District, Shanghai 200127, China
2
HiSilicon (Shanghai) Technologies Co., Ltd., Shanghai 201721, China
3
Goodwill Hessian Health Technology Co., Ltd., Beijing 100085, China
and 43.3% in the prospective validation cohort, respectively. Multivariate analysis found that pre-ablation treatment, AFP, CEA, CA19-9, ALBI grade, tumor number, and tumor size (hazard ratio [ 1, P \ 0.05) were independent risk factors for OS. A nomogram was developed based on these seven variables. The calibration curve for predicting the probability of survival showed a good agreement between the nomogram and actual observation both in the primary (concrete index: 0.699) and validation cohorts (concrete index: 0.734). Conclusions This simple nomogram based on seven variables including ALBI grade offers personalized prognostic data for HCC patients after ablation. Level of Evidence Level 4, case series. Keywords Hepatocellular carcinoma Percutaneous thermal ablation Prognostic nomogram Abbreviations ALBI Albumin–bilirubin HCC Hepatocellular carcinoma rHCC Recurrent hepatocellular carcinoma RFA Radiofrequency ablation MWA Microwave ablation BCLC Barcelona clinic liver cancer TNM Tumor-lymph node-metastasis CLIP Cancer of the Liver Italian Program CUPI The Chinese University Prognostic Index PALBI Platelet–albumin–bili
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