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Nomogram predicting extrahepatic metastasis of hepatocellular carcinoma based on commonly available clinical data.

ABSTRACT: Background and Aim:Extrahepatic metastasis (EHM) of hepatocellular carcinoma (HCC) leads to a worse prognosis. We aimed to develop a nomogram based on noninvasive pretreatment clinical data to predict EHM of HCC sooner. Methods:Three cohorts containing 1820, 479, and 988 HCC patients were enrolled from three hospitals in different regions in Taiwan and served as the training and validation cohorts. Pretreatment clinical data were analyzed by Cox regression modeling for independent risk factors of EHM. Results:Platelet count???200?×?103/?L, serum alfa-fetoprotein???100?ng/dL, tumor size???3 cm, tumor number?>?1, and macrovascular invasion were independent risk factors for EHM and were used to develop a nomogram. This nomogram had concordance indices of 0.733 (95% confidence interval [CI]: 0.688-0.778) and 0.739 (95% CI: 0.692-0.787) for the prediction of EHM during a 5-year follow-up duration in the training and validation cohorts, respectively. A nomogram score?>?61 implied a high risk of EHM (hazard ratio [HR]?=?3.83; 95% CI: 2.77-5.31, P?

SUBMITTER: Lee CH

PROVIDER: S-EPMC6386739 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Nomogram predicting extrahepatic metastasis of hepatocellular carcinoma based on commonly available clinical data.

Lee Chern-Horng CH Chang Chee-Jen CJ Lin Yu-Jr YJ Yen Cho-Li CL Shen Chien-Heng CH Cheng Ya-Ting YT Lin Chen-Chun CC Hsieh Sen-Yung SY

JGH open : an open access journal of gastroenterology and hepatology 20181101 1

<h4>Background and aim</h4>Extrahepatic metastasis (EHM) of hepatocellular carcinoma (HCC) leads to a worse prognosis. We aimed to develop a nomogram based on noninvasive pretreatment clinical data to predict EHM of HCC sooner.<h4>Methods</h4>Three cohorts containing 1820, 479, and 988 HCC patients were enrolled from three hospitals in different regions in Taiwan and served as the training and validation cohorts. Pretreatment clinical data were analyzed by Cox regression modeling for independent ...[more]

PMID: 30834339

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Project description:BackgroundExtrahepatic metastasis is the independent risk factor of poor survival of primary hepatic carcinoma (PHC), and most occurs in the chest and abdomen. Currently, there is still no available method to predict thoracoabdominal extrahepatic metastasis in PHC. In this study, a novel nomogram model was developed and validated for prediction of thoracoabdominal extrahepatic metastasis in PHC, thereby conducted individualized risk management for pretreatment different risk population.MethodsThe nomogram model was developed in a primary study that consisted of 330 consecutive pretreatment patients with PHC. Large-scale datasets were extracted from clinical practice. The nomogram was based on the predictors optimized by data dimension reduction through Lasso regression. The prediction performance was measured by the area under the receiver operating characteristic (AUROC), and calibrated to decrease the overfit bias. Individualized risk management was conducted by weighing the net benefit of different risk population via decision curve analysis. The prediction performance was internally and independently validated, respectively. An independent-validation study using a separate set of 107 consecutive patients.ResultsFour predictors from 55 high-dimensional clinical datasets, including size, portal vein tumor thrombus, infection, and carbohydrate antigen 125, were incorporated to develop a nomogram model. The nomogram demonstrated valuable prediction performance with AUROC of 0.830 (0.803 in internal-validation, and 0.773 in independent-validation, respectively), and fine calibration. Individual risk probability was visually scored. Weighing the net benefit, threshold probability was classified for three-independent risk population, which was < 19.9%, 19.9-71.8% and > 71.8%, respectively. According to this classification, pretreatment risk management was based on a treatment-flowchart for individualized clinical decision-making.ConclusionsThe proposed nomogram is a useful tool for pretreatment risk management of thoracoabdominal extrahepatic metastasis in PHC for the first time, and may handily facilitate timely individualized clinical decision-making for different risk population.

Dataset Information

Nomogram predicting extrahepatic metastasis of hepatocellular carcinoma based on commonly available clinical data.

Publications

Nomogram predicting extrahepatic metastasis of hepatocellular carcinoma based on commonly available clinical data.

Similar Datasets

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