Zeng Shicong, Wang Zongwen, Zhu Qiankun, Li Xiaodong, Ren Haiyang, Qian Bo, Hu Fengli, Xu Lishan, Zhai Bo
Department of Surgical Oncology and Hepatobiliary Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Gastroenterology, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Transl Cancer Res. 2023 Jan 30;12(1):93-112. doi: 10.21037/tcr-22-1912. Epub 2023 Jan 5.
The aim of this study was to develop nomograms to predict the risk of intrahepatic vascular invasion (IVI) of hepatocellular carcinoma (HCC) patients and estimate the overall survival (OS) and cancer-specific survival (CSS) of HCC patients with IVI.
The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients with HCC from 2010 to 2015. Ultimately, 1,287 HCC patients with IVI were included in this study and randomly divided into training (n=901) and validation (n=386) cohorts. Multivariate logistic regression analysis and multivariate Cox proportional hazards regression analysis were performed to construct nomograms to visually quantify the risk of IVI in patients with HCC and predict the prognosis. The prediction effect of nomograms was evaluated using Harrell's concordance index (C-index), receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA), respectively.
The C-index of the nomogram for risk prediction was 0.730. The C-indices based on the nomogram were 0.762 [95% confidence interval (CI): 0.745-0.779] and 0.770 (95% CI: 0.753-0.787) for OS and CSS prediction in the training cohort, respectively. In the validation cohort, the C-indices were 0.779 (95% CI: 0.752-0.806) and 0.795 (95% CI: 0.768-0.822) for OS prediction and CSS prediction, respectively. Overall, the ROC curve, calibration plots, and DCA indicated the good performance of nomograms.
We identified the relevant risk and prognostic factors for IVI in patients with HCC. The nomograms performed well on validation and may help to facilitate clinical decision-making.
本研究旨在开发列线图以预测肝细胞癌（HCC）患者肝内血管侵犯（IVI）的风险，并估计发生IVI的HCC患者的总生存期（OS）和癌症特异性生存期（CSS）。
利用监测、流行病学和最终结果（SEER）数据库识别2010年至2015年的HCC患者。最终，1287例发生IVI的HCC患者纳入本研究，并随机分为训练队列（n = 901）和验证队列（n = 386）。进行多因素逻辑回归分析和多因素Cox比例风险回归分析以构建列线图，直观量化HCC患者IVI的风险并预测预后。分别使用Harrell一致性指数（C指数）、受试者操作特征（ROC）曲线、校准图和决策曲线分析（DCA）评估列线图的预测效果。
风险预测列线图的C指数为0.730。在训练队列中，基于列线图的OS和CSS预测的C指数分别为0.762 [95%置信区间（CI）：0.745 - 0.779]和0.770（95% CI：0.753 - 0.787）。在验证队列中，OS预测和CSS预测的C指数分别为0.779（95% CI：0.752 - 0.806）和0.795（95% CI：0.768 - 0.822）。总体而言，ROC曲线、校准图和DCA表明列线图性能良好。
我们确定了HCC患者IVI的相关风险和预后因素。列线图在验证中表现良好，可能有助于促进临床决策。
