Tang Xiaomeng, Wang Qi, Jin Ronghua, Hu Caixia
Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, People's Republic of China.
Beijing Institute of Infectious Diseases, Beijing, People's Republic of China.
J Hepatocell Carcinoma. 2024 May 17;11:901-911. doi: 10.2147/JHC.S459250. eCollection 2024.
Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer. Early diagnosis is crucial for improving prognosis. Elderly HCC patients often have underlying liver diseases such as chronic hepatitis and cirrhosis, leading to impaired liver function and suboptimal liver reserve. Radiofrequency ablation (RFA) has rapidly become one of the most important methods for treating early-stage hepatocellular carcinoma (EHCC) due to its advantages, including minimal trauma, short operation time, less intraoperative bleeding, quick postoperative recovery, cost-effectiveness, and few postoperative-complications. However, the prognostic model for early recurrence after local ablation in elderly EHCC patients has not been widely evaluated. We have developed a prognostic model for the recurrence of local RFA in elderly EHCC patients. This is expected to provide a new early warning system for preventing early recurrence in elderly EHCC patients, prolonging patient's life, and improving overall quality of life.
In this study, we included 661 EHCC patients who underwent local ablation, dividing them into a Primary cohort and a Validation cohort in a 7:3 ratio. We characterized the cohorts and utilized the primary cohort to develop a prognostic nomogram model for recurrence after local ablation in elderly EHCC patients. Additionally, the validation cohort was used to assess the potential of the nomogram as a non-invasive biomarker for post-ablation recurrence in EHCC.
The user-friendly nomogram incorporates common clinical variables including gender, BCLC stage, tumor number, tumor size, red blood cell (RBC), gamma-glutamyl transferase (GGT), and prothrombin time activity (PTA). The nomogram constructed using the identified seven variables exhibits robust discriminatory capabilities, favorable predictive performance, and noteworthy clinical utility.
We developed a user-friendly nomogram based on the BCLC stage classification, which may provide prognostic assessments for elderly EHCC patients at 1, 3, and 5 years post-RFA.
肝细胞癌（HCC）是原发性肝癌的主要形式。早期诊断对于改善预后至关重要。老年HCC患者常伴有慢性肝炎和肝硬化等基础肝脏疾病，导致肝功能受损和肝脏储备功能欠佳。射频消融（RFA）因其具有创伤小、手术时间短、术中出血少、术后恢复快、性价比高及术后并发症少等优点，迅速成为治疗早期肝细胞癌（EHCC）的最重要方法之一。然而，老年EHCC患者局部消融后早期复发的预后模型尚未得到广泛评估。我们建立了老年EHCC患者局部RFA复发的预后模型。这有望为预防老年EHCC患者早期复发、延长患者生命及提高总体生活质量提供一种新的预警系统。
在本研究中，我们纳入了661例行局部消融的EHCC患者，按7:3的比例将他们分为一个主要队列和一个验证队列。我们对这些队列进行了特征描述，并利用主要队列建立了老年EHCC患者局部消融后复发的预后列线图模型。此外，验证队列用于评估该列线图作为EHCC消融后复发的非侵入性生物标志物的潜力。
这个用户友好型列线图纳入了常见的临床变量，包括性别、BCLC分期、肿瘤数量、肿瘤大小、红细胞（RBC）、γ-谷氨酰转移酶（GGT）和凝血酶原时间活动度（PTA）。使用确定的七个变量构建的列线图具有强大的辨别能力、良好的预测性能和显著的临床实用性。
我们基于BCLC分期分类开发了一个用户友好型列线图，可为老年EHCC患者RFA术后1年、3年和5年提供预后评估。
