Establishment and validation of a prognostic model based on preoperative serum prealbumin levels for patients with unresectable hepatocellular carcinoma receiving TACE treatment
10.3969/j.issn.1008-794X.2024.07.013
- VernacularTitle:血清前白蛋白对TACE治疗不可切除肝细胞癌预后模型的建立与验证
- Author:
Lin XU
1
;
Dongxu ZHAO
;
Zhongheng HOU
;
Caifang NI
Author Information
1. 215006 江苏苏州 苏州大学附属第一医院
- Keywords:
hepatocellular carcinoma;
prealbumin;
nomogram;
prognosis;
overall survival
- From:
Journal of Interventional Radiology
2024;33(7):767-774
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish a prognostic nomogram based on preoperative serum prealbumin levels for predicting overall survival(OS)in patients with unresectable hepatocellular carcinoma(HCC)treated with transcatheter arterial chemoembolization(TACE).Methods A total of 1 041 patients with unresectable HCC,who received TACE treatment at five medical centers in Suzhou city of China between January 2007 and December 2018,were divided into a training cohort(n=768)and a validation cohort(n=273).Cox regression analysis was used to analyzed the independent factors affecting one-,2-,and 3-year OS,based on which the nomogram was constructed,and validation of the nomogram was conducted in an internal test sequence.The performance of the nomogram was evaluated by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curve,and judgment curve analysis(DCA).Results COX regression analysis showed that AFP,BCLC,HBV,intrahepatic vascular invasion,number of tumors,PALB,PS,and tumor size were the independent risk factors affecting OS in patients with unresectable HCC treated with TACE.The C-index in the nomogram was 0.739(95％CI:0.719-0.759)for the training cohort and 0.715(95％CI:0.678-0.752)for the verification cohort.The AUCs of one-,2-,and 3-year OS in the training cohort were 0.877,0.794,and 0.799 respectively,which in the verification cohort were 0.840,0.741,and 0.671 respectively.The AUC-ROC values of the nomogram were higher than those of other traditional scoring systems,indicating that the nomogram had a good discriminatory power.The calibration curves demonstrated that a strong agreement existed between the predicted values of the nomogram and the actual observed values,and the DCA showed that the nomogram had high potential clinical utilization.The nomogram risk score revealed that the survival rate of patients in the low-risk group was significantly higher than that of patients in the high-risk group.Conclusion The nomogram based on preoperative serum prealbumin levels has excellent ability in predicting the prognosis of patients with unresectable HCC treated with TACE.
