Novel Prognostic Nomograms for Hepatocellular Carcinoma Patients with Microvascular Invasion: Experience from a Single Center
- Author:
Liangliang XU
1
;
Lian LI
;
Peng WANG
;
Ming ZHANG
;
Yanfang ZHANG
;
Xiangyong HAO
;
Lvnan YAN
;
Bo LI
;
Tianfu WEN
;
Mingqing XU
Author Information
- Publication Type:Original Article
- Keywords: Carcinoma, hepatocellular; Microvascular invasion; Hepatectomy; Prognosis; Nomogram
- MeSH: Calibration; Carcinoma, Hepatocellular; Cohort Studies; Disease-Free Survival; Hepatectomy; Humans; Multivariate Analysis; Nomograms; Prognosis; Risk Factors; Survival Rate
- From:Gut and Liver 2019;13(6):669-682
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Microvascular invasion (MVI) is an established risk factor for hepatocellular carcinoma (HCC). However, prediction models that specifically focus on the individual prognoses of HCC patients with MVI is lacking. METHODS: A total of 385 HCC patients with MVI were randomly assigned to training and validation cohorts in a 2:1 ratio. The outcomes were disease-free survival (DFS) and overall survival (OS). Prognostic nomograms were established based on the results of multivariate analyses. The concordance index (C-index), calibration plots and Kaplan-Meier curves were employed to evaluate the accuracy, calibration and discriminatory ability of the models. RESULTS: The independent risk factors for both DFS and OS included age, tumor size, tumor number, the presence of gross vascular invasion, and the presence of Glisson's capsule invasion. The platelet-to-lymphocyte ratio was another risk factor for OS. On the basis of these predictors, two nomograms for DFS and OS were constructed. The C-index values of the nomograms for DFS and OS were 0.712 (95% confidence interval [CI], 0.679 to 0.745; p<0.001) and 0.698 (95% CI, 0.657 to 0.739; p<0.001), respectively, in the training cohort and 0.704 (95% CI, 0.650 to 0.708; p<0.001) and 0.673 (95% CI, 0.607 to 0.739; p<0.001), respectively, in the validation cohort. The calibration curves showed optimal agreement between the predicted and observed survival rates. The Kaplan-Meier curves suggested that these two nomograms had satisfactory discriminatory abilities. CONCLUSIONS: These novel predictive models have satisfactory accuracy and discriminatory abilities in predicting the prognosis of HCC patients with MVI after hepatectomy.
