Yang YP, Guo CJ, Gu ZX, Hua JJ, Zhang JX, Shi J. Conditional survival probability of distant-metastatic hepatocellular carcinoma: A population-based study. World J Gastrointest Oncol 2023; 15(11): 1874-1890 [PMID: 38077643 DOI: 10.4251/wjgo.v15.i11.1874]
Corresponding Author of This Article
Jian Shi, MD, PhD, Attending Doctor, Department of General Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. atishoo@jlu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yong-Ping Yang, Cheng-Jun Guo, Zhao-Xuan Gu, Jun-Jie Hua, Jia-Xuan Zhang, Jian Shi, Department of General Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Shi J conceived and designed the study; Yang YP and Guo CJ collected the data, developed the analytic pipeline; Yang YP, Gu ZX, and Hua JJ led the analysis, generated the tables and figures, and wrote the manuscript; Yang YP, Guo CJ, and Zhang JX verified and processed the underlying data; and all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed by the Medical Ethics Committee of the Second Hospital of Jilin University; all our data comes from a public database (the SEER database) and needs no ethical approval.
Informed consent statement: As the study only involved retrospective chart reviews, informed written consents were not required in accordance with institutional IRB policy.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All of the data used in this study were downloaded from a public database (the SEER database).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Shi, MD, PhD, Attending Doctor, Department of General Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. atishoo@jlu.edu.cn
Received: June 24, 2023 Peer-review started: June 24, 2023 First decision: August 8, 2023 Revised: August 20, 2023 Accepted: September 6, 2023 Article in press: September 6, 2023 Published online: November 15, 2023 Processing time: 144 Days and 3.6 Hours
ARTICLE HIGHLIGHTS
Research background
Distant metastatic hepatocellular carcinoma (HCC) patients have poor survival rates, while some of them who have survived for several months may have a better prognosis than the prediction at initial diagnosis. Conditional survival (CS) could provide patients with survival probabilities at a specific time since the prognosis would be adjusted for the time the patient had already survived.
Research motivation
In this study, we evaluated actual survival and CS of distant metastatic HCC patients.
Research objectives
This study aimed to evaluate the CS of distant metastatic HCC patients and construct nomograms to predict CS at different times.
Research methods
We used Cox regression analysis to identify risk factors for overall survival (OS) and the competing risk model to identify risk factors for cancer-specific survival (CSS). Six-month CS was used to calculate the probability of survival for an additional 6 mo at a specific time after the initial diagnosis. We used standardized differences to evaluate the survival differences between subgroups. Nomograms were constructed to predict CS.
Research results
Using univariate and multivariate analysis, we found positive α-fetoprotein expression, higher T stage (T3 and T4), N1 stage, non-primary site surgery, non-chemotherapy, non-radiotherapy, and lung metastasis to be independent risk factors for actual OS and CSS. We found that actual survival rates decreased over time, while CS rates gradually increased. The influence of chemotherapy and radiotherapy on survival gradually disappeared over time; the influence of age and gender on survival gradually appeared; and the influence of lung metastasis reversed. The area under the curve (AUC) of nomograms for conditional OS decreased as time passed, and the AUC for conditional CSS gradually increased.
Research conclusions
Actual survival rates decreased over time, while CS rates gradually increased. With dynamic risk factors, nomograms constructed at different time would provide more accurate CS.
Research perspectives
CS could be used to evaluate the dynamic survival rates for distant metastatic HCC patients.
