Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13250-13263
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13250
Prognostic factors for disease-free survival in postoperative patients with hepatocellular carcinoma and construction of a nomogram model
Pan-Quan Luo, Zheng-Hui Ye, Li-Xiang Zhang, En-Dong Song, Zhi-Jian Wei, A-Man Xu, Zhen Lu
Pan-Quan Luo, Zheng-Hui Ye, Li-Xiang Zhang, En-Dong Song, Zhi-Jian Wei, A-Man Xu, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China
Zhen Lu, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230011, Anhui Province, China
Zhen Lu, Anhui Public Health Clinical Center, Hefei 230011, Anhui Province, China
Author contributions: Luo PQ, Ye ZH and Zhang LX contribute equally to this manuscript. Luo PQ collected the patients’ clinical information, performed the statistical analysis, and completed writing of the manuscript; Ye ZH and Zhang LX assisted in collecting the patients’ clinical information and writing the manuscript; Song ED helped them.; Lu Z, Xu AM and Wei ZJ designed the main study and critically revised the manuscript; All authors read and approved the final manuscript.
Supported by Research Fund Project of Anhui Institute of Translational Medicine, No. 2021zhyx-C54; Foundation of Anhui Medical University, No. 2019xkj146; and National and Provincial Key Specialty Construction Plan, No. Z155080000004.
Institutional review board statement: The present study was reviewed and approved by Ethics Committee of The First Hospital of Anhui Medical University (Approval No. PJ 2022-12-11).
Informed consent statement: Patients were not required to give informed consent for this study as the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used and/or analyzed during the current study were obtained from the Department of Gastrointestinal Surgery, the First Hospital of Anhui University. The data are available from the corresponding author on reasonable request.
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: Zhen Lu, Doctor, Professor, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, No. 100 Huaihai Road, Xinzhan District, Hefei 230011, Anhui Province, China. aydyingsc@sina.cn
Received: August 12, 2022
Peer-review started: August 12, 2022
First decision: September 4, 2022
Revised: September 15, 2022
Accepted: November 25, 2022
Article in press: November 25, 2022
Published online: December 26, 2022
Processing time: 136 Days and 8.6 Hours
Abstract
BACKGROUND

Hepatocellular carcinoma (HCC) is the most common type of liver cancer and has a high risk of invasion and metastasis along with a poor prognosis.

AIM

To investigate the independent predictive markers for disease-free survival (DFS) in patients with HCC and establish a trustworthy nomogram.

METHODS

In this study, 445 patients who were hospitalized in The First Affiliated Hospital of Anhui Medical College between December 2009 and December 2014 were retrospectively examined. The survival curve was plotted using the Kaplan–Meier method and survival was determined using the log-rank test. To identify the prognostic variables, multivariate Cox regression analyses were carried out. To predict the DFS in patients with HCC, a nomogram was created. C-indices and receiver operator characteristic curves were used to evaluate the nomogram's performance. Decision curve analysis (DCA) was used to evaluate the clinical application value of the nomogram.

RESULTS

Longer DFS was observed in patients with the following characteristics: elderly, I–II stage, and no history of hepatitis B. The calibration curve showed that this nomogram was reliable and had a higher area under the curve value than the tumor node metastasis (TNM) stage. Moreover, the DCA curve revealed that the nomogram had good clinical applicability in predicting 3- and 5-year DFS in HCC patients after surgery.

CONCLUSION

Age, TNM stage, and history of hepatitis B infection were independent factors for DFS in HCC patients, and a novel nomogram for DFS of HCC patients was created and validated.

Keywords: Hepatocellular carcinoma; Disease-free survival; Prognosis; Nomogram

Core Tip: In this study, age, tumor node metastasis (TNM) stage, and hepatitis B history were shown to be independent predictors of disease-free survival (DFS) in individuals with hepatocellular carcinoma (HCC). Additionally, we developed and validated a new nomogram for estimating 3- and 5-year DFS in HCC patients. The calibration curves of the nomogram were reliable, and the new nomogram had a higher area under the curve value than the TNM stage. We believe that our findings will be of interest to the readers of the World Journal of Clinical Cases.