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Prognostic Nomogram for Patients with Hepatocellular Carcinoma After Thermal Ablation

  • Clinical Investigation
  • Interventiional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To develop an effective prognostic nomogram for patients with hepatocellular carcinoma (HCC) after thermal ablation.

Methods

A total of 772 patients with intrahepatic primary or recurrent HCC who underwent radiofrequency ablation or microwave ablation between March 2011 and October 2016 were included. 602 patients (mean age, 56.0 ± 11.9 years; 495 male/107 female) were included in the primary cohort to establish a prognostic nomogram. Significant prognostic factors for overall survival (OS) identified by Cox univariate and multivariate regression analyses were used to construct the nomogram. The remaining 170 patients (mean age, 55.9 ± 11.9 years; 145 male/25 female) were used to validate the predictive accuracy of the nomogram.

Results

During a mean follow-up period of 26 months (range 1–85 months), the median OS periods were 48.6 months and 44.0 months for the primary and validation cohorts. The 1-, 3-, and 5-year OS rates were 85.5%, 61.4%, and 43.3% in the primary cohort and 84.7%, 59.6%, and 43.3% in the prospective validation cohort, respectively. Multivariate analysis found that pre-ablation treatment, AFP, CEA, CA19-9, ALBI grade, tumor number, and tumor size (hazard ratio > 1, P < 0.05) were independent risk factors for OS. A nomogram was developed based on these seven variables. The calibration curve for predicting the probability of survival showed a good agreement between the nomogram and actual observation both in the primary (concrete index: 0.699) and validation cohorts (concrete index: 0.734).

Conclusions

This simple nomogram based on seven variables including ALBI grade offers personalized prognostic data for HCC patients after ablation.

Level of Evidence

Level 4, case series.

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Abbreviations

ALBI:

Albumin–bilirubin

HCC:

Hepatocellular carcinoma

rHCC:

Recurrent hepatocellular carcinoma

RFA:

Radiofrequency ablation

MWA:

Microwave ablation

BCLC:

Barcelona clinic liver cancer

TNM:

Tumor-lymph node-metastasis

CLIP:

Cancer of the Liver Italian Program

CUPI:

The Chinese University Prognostic Index

PALBI:

Platelet–albumin–bilirubin

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

TB:

Total bilirubin

ALB:

Serum albumin

Scr:

Serum creatinine

WBC:

White blood cell count

PLT:

Platelet count

INR:

International normalized ratio

AFP:

Alpha fetoprotein

CEA:

Carcinoembryonic antigen

CA 19-9:

Carbohydrate Antigen 19-9

C-index:

Concordance index

OS:

Overall survival

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Acknowledgements

This work was supported in part by Goodwill Hessian Health Technology Co., of which Mingchen Zhao is a full-time employee.

Funding

This study was funded by the National Science and Technology Major Project (No. 2017ZX10203206-006-002).

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Author notes

  1. Min Ding and Xiaodong Zhao have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao-tong University, No. 160, Pujian Road, Pudong New District, Shanghai, 200127, China

    Min Ding, Yaoping Shi, Tao Wang, Dan Cui, Donghua Shi & Bo Zhai

  2. HiSilicon (Shanghai) Technologies Co., Ltd., Shanghai, 201721, China

    Xiaodong Zhao

  3. Goodwill Hessian Health Technology Co., Ltd., Beijing, 100085, China

    Mingchen Zhao

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  1. Min Ding
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Correspondence to Bo Zhai.

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Consent for publication was obtained for every individual person’s data included in the study.

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Ding, M., Zhao, X., Zhao, M. et al. Prognostic Nomogram for Patients with Hepatocellular Carcinoma After Thermal Ablation. Cardiovasc Intervent Radiol 43, 1621–1630 (2020). https://doi.org/10.1007/s00270-020-02617-z

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