Construction of a nomogram based on controlling nutritional status score for predicting the prognosis of hepatocellular carcinoma patients after receiving TACE
10.3969/j.issn.1008-794X.2023.12.006
- VernacularTitle:构建基于控制营养状况评分的列线图预测肝细胞癌TACE治疗患者预后
- Author:
Yifeng LU
1
;
Qi WANG
;
Zhongming HE
Author Information
1. 213000 江苏常州 苏州大学附属第三医院(常州市第一人民医院)介入放射科
- Keywords:
hepatocellular carcinoma;
transcatheter arterial chemoembolization;
controlling nutritional status score;
nomogram;
prognostic prediction
- From:
Journal of Interventional Radiology
2023;32(12):1190-1196
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical application of controlling nutritional status(CONUT)score in predicting the prognosis of hepatocellular carcinoma(HCC)patients who are treated with transarterial chemoembolization(TACE),and to construct a nomogram model integrated with multiple prognostic factors which help clinicians to accurately predict the prognosis of each patient.Methods The clinical data of 155 primary HCC patients,who were treated with TACE at the Third Affiliated Hospital of Soochow University of China between January 2017 and June 2020,were retrospectively analyzed.The optimal cutoff point of CONUT score was identified by receiver operation characteristics(ROC)curve and its prognostic significance was analyzed by Kaplan-Meier curve.The univariate and multivariate Cox survival analysis was performed to determine the independent prognostic factors for HCC patients treated with TACE.A nomogram model was constructed based on the significant variables which were obtained from the multivariate analysis,and its ability in predicting overall survival(OS)in HCC patients receiving TACE treatment was evaluated by using the consistency index(C-index).The calibration curves were plotted to evaluate the consistency between the predicted probability and the actual probability.Results The optimal cutoff point of CONUT score for predicting OS was 4,with an AUC value of 0.766(95％CI=0.691-0.841).The patients of high CONUT score group(≥4)had larger tumor diameter(P=0.014),higher serum AFP level(P=0.002),poorer hepatic function(P＜0.01),poorer response to TACE treatment(P＜0.01),and shorter median OS(P＜0.01).Child-Pugh grade,maximum tumor diameter,serum AFP level,BCLC stage,therapeutic response to TACE,and CONUT score were the independent predictors of OS in HCC patients after TACE treatment(all P＜0.05).Based on the above variables,the nomogram model was constructed,and its C-index was 0.785(95％CI=0.691-0.879).The calibration curves showed that a good consistency existed between the predicted probability of the model and the actual probability.Conclusion CONUT score is a simple and feasible tool for predicting the prognosis of HCC patients who are treated with TACE.The nomogram model integrated with tumor biological characteristics,therapeutic response to TACE treatment and CONUT score carries a reliable predictive ability,therefore,this model is worth further promotion and verification.(J Intervent Radiol,2023,32:1190-1196)
