Prognostic nomogram for patients with unresectable hepatocellular carcinoma after transcatheter arterial chemoembolization

Background & Aims To establish an effective prognostic nomogram for patients with unresectable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Methods The nomogram was constructed based on data obtained from a retrospective study on 2938 patients who received TACE as...

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Bibliographic Details
Published in:Journal of hepatology 2015-07, Vol.63 (1), p.122-130
Main Authors: Xu, Li, Peng, Zhen-Wei, Chen, Min-Shan, Shi, Ming, Zhang, Yao-Jun, Guo, Rong-Ping, Lin, Xiao-Jun, Lau, Wan-Yee
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antineoplastic Agents - administration & dosage
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Catheterization, Peripheral
Chemoembolization, Therapeutic - methods
Female
Follow-Up Studies
Gastroenterology and Hepatology
Hepatocellular carcinoma
Humans
Injections, Intra-Arterial
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Male
Middle Aged
Neoplasm Staging
Nomograms
Prognosis
Prognostic nomogram
Prospective Studies
Staging system
Transarterial chemoembolization
Young Adult
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Summary:Background & Aims To establish an effective prognostic nomogram for patients with unresectable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Methods The nomogram was constructed based on data obtained from a retrospective study on 2938 patients who received TACE as an initial therapy from 2000 to 2008. The predictive accuracy and discriminative ability of the nomogram were compared with seven current commonly used staging systems on HCC by using data obtained from a prospective study on a cohort of 647 patients treated from January 2011 to December 2011 at the same institution. Additional external validation was performed using a data set (n = 221) from another institution. Results Portal vein invasion, tumor number, tumor capsule, alpha fetoprotein, aspartate aminotransferase, and indocyanine green retention at 15 min formed the basis of the nomogram. The concordance index (C-index) of the nomogram was 0.755, which was significantly better than the American Joint Committee on Cancer seventh edition (0.612), the Barcelona Clinic Liver Cancer system (0.692), the Okuda system (0.579), the Japan Integrated Staging system (0.637), Cancer of the Liver Italian Program system (0.683), the Chinese University Prognostic Index (0.637) and the Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire (0.577) ( p
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2015.02.034