Nomogram prediction of individual prognosis of patients with hepatocellular carcinoma View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-01-31

AUTHORS

Gang Wan, Fangyuan Gao, Jialiang Chen, Yuxin Li, Mingfan Geng, Le Sun, Yao Liu, Huimin Liu, Xue Yang, Rui Wang, Ying Feng, Xianbo Wang

ABSTRACT

BackgroundThe purpose of this study was to develop an effective nomogram capable of estimating the individual survival outcomes of patients with hepatocellular carcinoma (HCC), and compare the predictive accuracy and discriminative ability with other staging systems.MethodsThe nomogram was established based on a retrospective study of 661 patients newly diagnosed with HCC at the Beijing Ditan Hospital (Beijing, China), Capital Medical University, between October 2008 and July 2012. The predictive accuracy and discriminative ability of the previously developed nomogram were assessed by C-index and calibration curves, and were compared to seven current commonly used staging systems. The results were validated, using a bootstrap approach to correct for bias, in a prospective study of 220 patients consecutively enrolled between August 2012 and March 2013.ResultsMultivariate analysis of the primary cohort for survival analysis identified the independent factors to be aspartate aminotransferase, ɣ-glutamyl transpeptidase, white blood cell count, neutrophil-to-lymphocyte ratio, prothrombin activity, α-fetoprotein, tumor number and size, lymph node metastasis, and portal vein involvement, which were all included to build the nomogram. The calibration curve for predicting the probability of survival showed consistency between the nomogram and the actual observation. The C-index of the nomogram was 0.81 (95% confidence interval, 0.79–0.82), which was statistically better than that of the Tumor, Node, Metastasis staging (0.71), Barcelona Clinic Liver Cancer staging (0.77), Okuda (0.62), Japan Integrated Staging (0.73), Cancer of the Liver Italian Program score (0.76), Chinese University Prognostic Index (0.68), and the Groupe d’ Etude et de Traitement du Carcinome Hepatocellulaire Prognostic classification (0.65) (p < 0.001 for all). The results were validated in the prospective validation cohort.ConclusionsThe prognostic nomogram resulted in more accurate individualized risk estimates for overall survival in HCC patients. More... »

PAGES

91

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12885-017-3062-6

DOI

http://dx.doi.org/10.1186/s12885-017-3062-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1083399520

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28143427


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29 schema:description BackgroundThe purpose of this study was to develop an effective nomogram capable of estimating the individual survival outcomes of patients with hepatocellular carcinoma (HCC), and compare the predictive accuracy and discriminative ability with other staging systems.MethodsThe nomogram was established based on a retrospective study of 661 patients newly diagnosed with HCC at the Beijing Ditan Hospital (Beijing, China), Capital Medical University, between October 2008 and July 2012. The predictive accuracy and discriminative ability of the previously developed nomogram were assessed by C-index and calibration curves, and were compared to seven current commonly used staging systems. The results were validated, using a bootstrap approach to correct for bias, in a prospective study of 220 patients consecutively enrolled between August 2012 and March 2013.ResultsMultivariate analysis of the primary cohort for survival analysis identified the independent factors to be aspartate aminotransferase, ɣ-glutamyl transpeptidase, white blood cell count, neutrophil-to-lymphocyte ratio, prothrombin activity, α-fetoprotein, tumor number and size, lymph node metastasis, and portal vein involvement, which were all included to build the nomogram. The calibration curve for predicting the probability of survival showed consistency between the nomogram and the actual observation. The C-index of the nomogram was 0.81 (95% confidence interval, 0.79–0.82), which was statistically better than that of the Tumor, Node, Metastasis staging (0.71), Barcelona Clinic Liver Cancer staging (0.77), Okuda (0.62), Japan Integrated Staging (0.73), Cancer of the Liver Italian Program score (0.76), Chinese University Prognostic Index (0.68), and the Groupe d’ Etude et de Traitement du Carcinome Hepatocellulaire Prognostic classification (0.65) (p < 0.001 for all). The results were validated in the prospective validation cohort.ConclusionsThe prognostic nomogram resulted in more accurate individualized risk estimates for overall survival in HCC patients.
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35 schema:keywords Barcelona Clinic Liver Cancer (BCLC) staging
36 Beijing Ditan Hospital
37 C-index
38 Capital Medical University
39 Chinese University Prognostic Index
40 Ditan Hospital
41 Etude
42 Groupe d
43 HCC patients
44 Japan Integrated Staging
45 Liver Italian Program (CLIP) score
46 Medical University
47 Okuda
48 Program score
49 University
50 ability
51 accuracy
52 activity
53 actual observations
54 aminotransferase
55 analysis
56 approach
57 aspartate aminotransferase
58 bias
59 blood cell count
60 bootstrap approach
61 calibration curve
62 cancer
63 cancer staging
64 carcinoma
65 cell count
66 classification
67 cohort
68 consistency
69 count
70 curves
71 discriminative ability
72 effective nomogram
73 estimates
74 factors
75 glutamyl transpeptidase
76 hepatocellular carcinoma
77 hospital
78 independent factors
79 index
80 individual prognosis
81 individual survival outcomes
82 individualized risk estimates
83 involvement
84 lymph node metastasis
85 lymphocyte ratio
86 metastasis
87 metastasis staging
88 neutrophils
89 node metastasis
90 nodes
91 nomogram
92 nomogram prediction
93 number
94 observations
95 outcomes
96 overall survival
97 patients
98 portal vein involvement
99 prediction
100 predictive accuracy
101 primary cohort
102 probability
103 probability of survival
104 prognosis
105 prognostic classification
106 prognostic index
107 prognostic nomogram
108 prospective study
109 prospective validation cohort
110 prothrombin activity
111 purpose
112 ratio
113 results
114 retrospective study
115 risk estimates
116 scores
117 size
118 staging
119 staging system
120 study
121 survival
122 survival analysis
123 survival outcomes
124 system
125 transpeptidase
126 tumor number
127 tumors
128 validation cohort
129 vein involvement
130 white blood cell count
131 α-fetoprotein
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