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. 2021 Jul 28:8:837-850.
doi: 10.2147/JHC.S308587. eCollection 2021.

Using the aMAP Risk Score to Predict Late Recurrence Following Radiofrequency Ablation for Hepatocellular Carcinoma in Chinese Population: A Multicenter Study

Yi Yang #  1 , Yanzhao Zhou #  2   3 , Xinyuan Zhang #  1 , Yujing Xin  1 , Yi Chen  1   4 , Qingsheng Fan  5 , Xiao Li  1 , Xi Wei  6 , Qiang Li  3 , Xiang Zhou  1 , Jinxue Zhou  2
Affiliations

Using the aMAP Risk Score to Predict Late Recurrence Following Radiofrequency Ablation for Hepatocellular Carcinoma in Chinese Population: A Multicenter Study

Yi Yang et al. J Hepatocell Carcinoma. .

Abstract

Objective: This study was conducted to explore the application of age-male-ALBI-platelets (aMAP) score for predicting late recurrence of hepatocellular carcinoma (HCC) following radiofrequency ablation (RFA) and develop an aMAP score based-nomogram to predict prognosis in Chinese population.

Materials and methods: HCC patients who developed late recurrence following RFA at National Cancer Center (NCC) of China, First Hospital of Shanxi Medical University and Beijing Hospital of Traditional Chinese Medicine from January 2011 to December 2016 were included as a training cohort, and patients who were treated at Affiliated Cancer Hospital of Zhengzhou University between January 2012 and December 2016 were included as an external validation cohort. The optimal cut-off value for aMAP score was determined using X-tile software to discriminate the performance of recurrence-free survival (RFS).

Results: A total of 339 eligible patients were included in this study. Patients were grouped into low-risk (aMAP score ≤64.2), medium-risk (64.3 ≤aMAP score ≤68.6) and high-risk (aMAP score ≥68.7) groups by X-tile plots. The prognostic factors that affected RFS were the number of lesions and aMAP score. A nomogram was constructed to predict the RFS with a C-index of 0.793 (95% CI: 0.744-0.842). The time-dependent receiver operating characteristic curves (t-AUCs) of the nomogram to predict 3, 4 and 5-year RFS were 0.808, 0.820 and 0.764, respectively. The model was then tested with data from an external validation cohort. The calibration curve confirmed the optimal agreement between the predicted and observed values.

Conclusion: The aMAP score provided a well-discriminated risk stratification and is an independent prognostic factor for the late recurrence of HCC following RFA. The aMAP score-based nomogram could help to strengthen prognosis-based decision making and formulate adjuvant therapeutic and preventive strategies.

Keywords: age-male-ALBI-platelets score; hepatocellular carcinoma; radiofrequency ablation; recurrence-free survival.

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Conflict of interest statement

The authors of this manuscript declare that there are no relationships with any companies, whose products or services may be related to the subject matter of the article.

Figures

Figure 1
Figure 1
Flowchart for patient selection and study design.
Figure 2
Figure 2
X-tile plots used to generate optimal cut-off values of aMAP.
Figure 3
Figure 3
Kaplan-Meier curves for: (A) RFS; and (B) OS of patients in low, medium, and high-risk groups; Patterns of late recurrence in the study (C); Kaplan-Meier curves for: (D) OS of patients with and without ER.
Figure 4
Figure 4
Nomogram to predict the RFS after RFA.
Figure 5
Figure 5
The t-ROC of the nomogram to predict: (A) 3-year; (B) 4-year; and (C) and 5-year RFS.
Figure 6
Figure 6
Calibration curves to predict the 3, 4, and 5-year RFS.
Figure 7
Figure 7
Kaplan-Meier curve for: (A) RFS; and (B) OS of patients in low, medium, and high-risk groups of external validation cohort.
Figure 8
Figure 8
T-ROC of the nomogram to predict: (A) 3-year; (B) 4-year; and (C) 5-year RFS in external validation cohort.
Figure 9
Figure 9
Calibration curves to predict the 3, 4, and 5-year RFS in external validation cohort.
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