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. 2021 Jun 29;21(1):751.
doi: 10.1186/s12885-021-08505-0.

Prognostic nomogram for hepatocellular carcinoma with radiofrequency ablation: a retrospective cohort study

Zhenhua Lu #  1   2 , Zhen Sun #  1   3 , Chengyu Liu  1   2 , Xiaolei Shi  1 , Rui Li  1   3 , Weiwei Shao  1 , Yangyang Zheng  1 , Yao Li  1 , Jinghai Song  4   5
Affiliations

Prognostic nomogram for hepatocellular carcinoma with radiofrequency ablation: a retrospective cohort study

Zhenhua Lu et al. BMC Cancer. .

Abstract

Background: Radiofrequency ablation (RFA) is an effective treatment option for hepatocellular carcinoma (HCC). This study aimed to analyze the prognostic factors of HCC patients treated with RFA and to develop nomograms for outcome prediction.

Methods: A total of 3142 HCC patients treated with RFA were recruited, and their data were collected from the Surveillance, Epidemiology, and End Results database. Univariate and multifactor Cox analyses were performed to identify independent prognostic factors. These factors were integrated into a nomogram to predict 3- and 5-year cancer-specific survival (CSS) and overall survival (OS). Consistency indices and calibration plots were used to assess the accuracy of the nomograms in both the internal and external cohorts.

Results: The median follow-up periods for HCC patients treated with RFA were 27 and 29 months for OS and CSS, respectively. Marital status, age, race, histological grade of differentiation, tumor size, T stage, and serum alpha-fetoprotein levels at the time of diagnosis were identified as prognostic factors for OS and CSS. Additionally, M stage was identified as risk factors for OS. These risk factors are included in the nomogram. The calibration plots of the OS and CSS nomograms showed excellent consistency between actual survival and nomogram predictions. The bootstrap-corrected concordance indices of the OS and CSS nomograms were 0.637 (95% CI, 0.628-0.646) and 0.670 (95% 0.661-0.679), respectively. Importantly, our nomogram performed better discriminatory compared with 8th edition tumor-node-metastasis (TNM) stage system for predicting OS and CSS.

Conclusions: We identified prognostic factors for HCC patients treated with RFA and provided an accurate and personalized survival prediction scheme.

Keywords: Cancer-specific survival (CSS); Hepatocellular carcinoma; Nomogram; Overall survival (OS); Radiofrequency ablation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the hepatocellular carcinoma patients with training and validation cohort
Fig. 2
Fig. 2
KM survival curve of age group and tumor size in overall survival and cancer-specific survival. A KM survival curve of age group in overall survival; B KM survival curve of age group in cancer-specific survival; C KM survival curve of tumor size group in overall survival; D KM survival curve of tumor size group in cancer-specific survival
Fig. 3
Fig. 3
Prognostic nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of HCC patients with radiofrequency ablation. A Prognostic nomograms to predict the overall survival (OS); B Prognostic nomograms to predict the cancer-specific survival (CSS)
Fig. 4
Fig. 4
Calibration plots of OS associated nomograms in both training and validation sets. A Calibration plots of 3-year OS in training set; B Calibration plots of 5-year OS in training set; C calibration plots of 3-year OS in validation set. D calibration plots of 5-year OS in validation set. OS, overall survival
Fig. 5
Fig. 5
Calibration plots of CSS associated nomograms in both training and validation sets. A Calibration plots of 3-year CSS in training set; B Calibration plots of 5-year CSS in training set; C calibration plots of 3-year CSS in validation set. D calibration plots of 5-year CSS in validation set. CSS, cancer-specific survival
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