A novel and validated prognostic nomogram based on liver fibrosis and tumor burden for patients with hepatocellular carcinoma after curative resection

作者：Huang, Jin-Long; Fu, Yi-Peng; Jing, Chu-Yu; Yi, Yong; Sun, Jian; Gan, Wei; Lu, Zhu-Feng; Zhou, Jian; Fan, Jia; Qiu, Shuang-Jian^*

来源：Journal of Surgical Oncology, 2018, 117(4): 625-633.

DOI：10.1002/jso.24895

• hepatocellular carcinoma
• laminin
• liver fibrosis
• nomogram
• prognostic factors

Background and ObjectivesMost conventional staging systems were formulated concerning the tumor burden rather than the severity of liver fibrosis, which plays a central role in tumor promotion. The aim of this study was to formulate a prognostic nomogram comprehensively considering these two aspects for HCC after hepatectomy. @@@ MethodsThe prognostic significances of the four indicators namely laminin, hyaluronic acid, human procollagen type-III, and collagen type-IV that reflect liver fibrosis were explored in two independent cohorts. A nomogram was established based on the results of multivariate analysis. The predictive accuracy of the nomogram was measured by concordance index (C-index) and calibration. The decision curve analysis (DCA) was used to evaluate the clinical benefit of the nomogram. @@@ ResultsPreoperative serum laminin level is an independent prognostic factor for overall survival in HCC patients after resection. The C-indices of the nomogram in the training and validation cohorts were 0.779 and 0.719, respectively. The calibration showed optimal agreement between the prediction by nomogram and actual observation. Moreover, the C-indices and DCA revealed that the nomogram provided better clinical benefit compared with the BCLC stage, CLIP score, and AJCC 7th edition. @@@ ConclusionsThe prognostic nomogram constructed on laminin represents a superior predictive model.

• 出版日期2018-3-15
• 单位复旦大学