Department of Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, Zhejiang Provincial Top Key Discipline in Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Biomed Res Int. 2021 Mar 29;2021:1658403. doi: 10.1155/2021/1658403. eCollection 2021.
Hepatocellular carcinoma (HCC) is the most common type among primary liver cancers (PLC). With its poor prognosis and survival rate, it is necessary for HCC patients to have a long-term follow-up. We believe that there are currently no relevant reports or literature about nomograms for predicting the cancer-specific mortality of HCC patients. Therefore, the primary goal of this study was to develop and evaluate nomograms to predict cancer-specific mortality and overall mortality. Data of 45,158 cases of HCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) program database between 2004 and 2013, which were then utilized to develop the nomograms. Finally, the performance of the nomograms was evaluated by the concordance index (C-index) and the area under the time-dependent receiver operating characteristic (ROC) curve (td-AUC). The categories selected to develop a nomogram for predicting cancer-specific mortality included marriage, insurance, radiotherapy, surgery, distant metastasis, lymphatic metastasis, tumor size, grade, sex, and the American Joint Committee on Cancer (AJCC) stage; while the marriage, radiotherapy, surgery, AJCC stage, grade, race, sex, and age were selected to develop a nomogram for predicting overall mortality. The C-indices for predicted 1-, 3-, and 5-year cancer-specific mortality were 0.792, 0.776, and 0.774; the AUC values for 1-, 3-, and 5-year cancer-specific mortality were 0.830, 0.830, and 0.830. The C-indices for predicted 1-, 3-, and 5-year overall mortality were 0.770, 0.755, and 0.752; AUC values for predicted 1-, 3-, and 5-year overall mortality were 0.820, 0.820, and 0.830. The results showed that the nomograms possessed good agreement compared with the observed outcomes. It could provide clinicians with a personalized predicted risk of death information to evaluate the potential changes of the disease-specific condition so that clinicians can adjust therapy options when combined with the actual condition of the patient, which is beneficial to patients.
肝细胞癌（HCC）是原发性肝癌（PLC）中最常见的类型。由于其预后不良和生存率低，HCC 患者需要进行长期随访。我们认为目前尚无关于预测 HCC 患者癌症特异性死亡率的列线图的相关报告或文献。因此，本研究的主要目标是开发和评估列线图以预测癌症特异性死亡率和总死亡率。本研究从 2004 年至 2013 年期间从监测、流行病学和最终结果（SEER）计划数据库中收集了 45158 例 HCC 患者的数据，然后利用这些数据开发了列线图。最后，通过一致性指数（C 指数）和时间依赖性接收器操作特征（ROC）曲线下面积（td-AUC）评估了列线图的性能。用于预测癌症特异性死亡率的列线图的分类包括婚姻、保险、放疗、手术、远处转移、淋巴转移、肿瘤大小、分级、性别和美国癌症联合委员会（AJCC）分期；而用于预测总死亡率的列线图的分类包括婚姻、放疗、手术、AJCC 分期、分级、种族、性别和年龄。预测 1、3 和 5 年癌症特异性死亡率的 C 指数分别为 0.792、0.776 和 0.774；1、3 和 5 年癌症特异性死亡率的 AUC 值分别为 0.830、0.830 和 0.830。预测 1、3 和 5 年总死亡率的 C 指数分别为 0.770、0.755 和 0.752；预测 1、3 和 5 年总死亡率的 AUC 值分别为 0.820、0.820 和 0.830。结果表明，与观察结果相比，列线图具有良好的一致性。它可以为临床医生提供个性化的死亡风险预测信息，以评估疾病特异性情况的潜在变化，以便临床医生可以结合患者的实际情况调整治疗方案，这对患者有益。
