Xia Wuzheng, Peng Tianyi, Guan Renguo, Zhou Yu, Zeng Cong, Lin Ye, Wu Zhongshi, Tan Hongmei
Department of Organ Transplant, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Ann Transl Med. 2021 Oct;9(20):1541. doi: 10.21037/atm-21-4837.
Hepatocellular carcinoma (HCC) is one of the most common malignant cancers worldwide. Curative resection is an effective treatment but HCC recurrence rates remain high. This study aimed to establish a novel prognostic nomogram to assess the risk of recurrence in patients following curative resection.
A total of 410 patients undergoing HCC curative resection were recruited from the Guangdong Provincial People's Hospital (GDPH). The cohort was divided into a training group (n=291) and a validation group (n=97). The risk factors for HCC early recurrence within 1 year of curative hepatectomy were identified. Finally, a multivariate prognostic nomogram was developed and validated.
Age, tumor number, tumor capsule, portal vein tumor thrombi, pathological grade, vascular tumor emboli, activated partial thromboplastin time (APTT), and tumor size were identified as independent prognostic risk factors for HCC early recurrence within 1 year of curative hepatectomy. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.806 [95% confidence interval (CI): 0.755 to 0.857; P<0.001], and no AUC/ROC statistical difference was detected between the training and validation sets.
The nomogram effectively predicted postoperative HCC recurrence within 1 year after curative hepatectomy, which may be a useful tool for the postoperative treatment or follow up for HCC patients.
肝细胞癌（HCC）是全球最常见的恶性肿瘤之一。根治性切除术是一种有效的治疗方法，但HCC复发率仍然很高。本研究旨在建立一种新的预后列线图，以评估根治性切除术后患者的复发风险。
从广东省人民医院招募了410例行HCC根治性切除术的患者。该队列分为训练组（n = 291）和验证组（n = 97）。确定了根治性肝切除术后1年内HCC早期复发的危险因素。最后，开发并验证了多因素预后列线图。
年龄、肿瘤数量、肿瘤包膜、门静脉癌栓、病理分级、血管癌栓、活化部分凝血活酶时间（APTT）和肿瘤大小被确定为根治性肝切除术后1年内HCC早期复发的独立预后危险因素。受试者工作特征（ROC）曲线下面积（AUC）为0.806 [95%置信区间（CI）：0.755至0.857；P < 0.001]，训练集和验证集之间未检测到AUC/ROC统计学差异。
该列线图有效地预测了根治性肝切除术后1年内HCC的术后复发，这可能是HCC患者术后治疗或随访的有用工具。
