Research Papers:

Prognostic nomogram for post-surgical treatment with adjuvant TACE in hepatitis B virus-related hepatocellular carcinoma

Hao Hu, Xi Kun Han, Xiao Ran Long, Jia Fan, Zhi Ping Yan, Jian Hua Wang and Rong Liu _

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Oncotarget. 2016; 7:58302-58314. https://doi.org/10.18632/oncotarget.11078

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Hao Hu1,*, Xi Kun Han2, Xiao Ran Long3,*, Jia Fan4, Zhi Ping Yan1, Jian Hua Wang1, Rong Liu1

1Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

2State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

3Sun Yat-sen University Cancer Center, Guangzhou, China

4Liver Cancer Institute, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

*These authors have contributed equally to this work

Correspondence to:

Rong Liu, email: [email protected]

Hao Hu, email: [email protected]

Keywords: nomogram, adjuvant transarterial chemoembolization, hepatocellular carcinoma

Received: May 16, 2016    Accepted: July 01, 2016    Published: August 05, 2016


Objective: This study sought to establish an effective and reliable prognostic nomogram to guide the decision for post-surgical adjuvant transarterial chemoembolization (PA-TACE) in patients with hepatitis B virus-related (HBV) hepatocellular carcinoma (HCC).

Results: The 1, 3, 5-year overall survival rates were, respectively, 87.7%, 52.1% and 28.3% in the patients from the derivation set and 91.7%, 57.1% and 34.1% in those from the validation set. Five risk factors (HBV-DNA level, platelet count, vascular invasion, change of Child-Pugh score, and tumor diameter) in the multivariate analysis were significantly associated with prognosis. The statistical nomogram incorporated these five factors achieved good calibration and discriminatory abilities with c-index of 0.75 (95% CI 0.67 to 0.83). The findings were supported by the independent external validation set (c-index, 0.69; 95% CI 0.56 to 0.83). Patients who had a nomogram score of less than 180 was considered to have higher survival benefit from PA-TACE.

Methods: The nomogram was established based on data obtained from a retrospective study on 235 consecutive patients with HBV HCC who received PA-TACE as an initial therapy from 2006 to 2010 in our center. 84 patients who were collected at another institution between 01/2008 and 12/2010 served as an external validation set. The prognostic nomogram was developed based on the data obtained before the PA-TACE procedure. Predictive accuracy and discriminative ability of the nomogram were assessed by concordance index (C-index), calibration curves, and validation set.

Conclusion: The novel nomogram may achieve an optimal prognostic prediction for PA-TACE in HBV-related HCC.

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