ArticleFrontiers in surgery2022
A Practical Nomogram and Risk Stratification System Predicting Cancer-Specific Survival for Hepatocellular Carcinoma Patients With Severe Liver Fibrosis.
Article in Frontiers in surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Establishment and validation of a predictive model of recurrence in primary hepatocellular carcinoma after resection.Journal of gastrointestinal oncology · 2023Article
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7 authors.
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Abstract
Objective: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. This study aims to construct a novel practical nomogram and risk stratification system to predict cancer-specific survival (CSS) in HCC patients with severe liver fibrosis. Methods: Data on 1,878 HCC patients with severe liver fibrosis in the period 1975 to 2017 were extracted from the Surveillance, Epidemiology, and End Results database (SEER). Patients were block-randomized (1,316 training cohort, 562 validation cohort) by setting random seed. Univariate and multivariate COX regression analyses were employed to select variables for the nomogram. The consistency index (C-index), the area under time-dependent receiver operating characteristic curve (time-dependent AUC), and calibration curves were used to evaluate the performance of the nomogram. Decision curve analysis (DCA), the C-index, the net reclassification index (NRI), and integrated discrimination improvement (IDI) were used to compare the nomogram with the AJCC tumor staging system. We also compared the risk stratification of the nomogram with the American Joint Committee on Cancer (AJCC) staging system. Results: Seven variables were selected to establish the nomogram. The C-index (training cohort: 0.781, 95%CI: 0.767-0.793; validation cohort: 0.793, 95%CI = 95%CI: 0.779-0.798) and the time-dependent AUCs (the training cohort: the values of 1-, 3-, and 5 years were 0.845, 0.835, and 0.842, respectively; the validation cohort: the values of 1-, 3-, and 5 years were 0.861, 0.870, and 0.876, respectively) showed satisfactory discrimination. The calibration plots also revealed that the nomogram was consistent with the actual observations. NRI (training cohort: 1-, 2-, and 3-year CSS: 0.42, 0.61, and 0.67; validation cohort: 1-, 2-, and 3-year CSS: 0.26, 0.52, and 0.72) and IDI (training cohort: 1-, 3-, and 5-year CSS:0.16, 0.20, and 0.22; validation cohort: 1-, 3-, and 5-year CSS: 0.17, 0.26, and 0.30) indicated that the established nomogram significantly outperformed the AJCC staging system ( Conclusion: A nomogram for predicting CSS for HCC patients with severe liver fibrosis was established and validated, which provided a new system of risk stratification as a practical tool for individualized treatment and management.
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