Prognostic group stratification and nomogram for predicting overall survival in patients who received radiotherapy for abdominal lymph node metastasis from hepatocellular carcinoma: a multi-institutional retrospective study (KROG 15-02)
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Youngkyong Kim1,*, Hee Chul Park2,*, Sang Min Yoon3,*, Tae Hyun Kim1, Jieun Lee2, Jinhyun Choi4, Jeong Il Yu2, Jin-Hong Park3, Jong Hoon Kim3, Joong-Won Park1 and Jinsil Seong4
1Center for Liver Cancer, National Cancer Center, Goyang, Korea
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
4Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
*These authors have contributed equally to this work
Tae Hyun Kim, email: firstname.lastname@example.org
Keywords: hepatocellular carcinoma, lymph node metastasis, survival, prognostic factor, nomogram
Received: August 07, 2017 Accepted: September 20, 2017 Published: October 10, 2017
Objective: To develop a prognostic model for overall survival (OS) in hepatocellular carcinoma (HCC) patients receiving radiotherapy (RT) to metastatic abdominal lymph nodes (LNs).
Materials and Methods: Two hundred twenty-eight patients treated with RT to metastatic abdominal LNs were retrospectively reviewed.
Results: Median OS in all patients was 11.1 months. LN responders had significantly higher median OS than non-responders (14.2 months vs. 7.5 months, p<0.05). On multivariate analysis, Child-Pugh classification, status of intrahepatic tumor, presence of distant metastasis, number and location of metastatic LNs, serum level of alpha fetoprotein (AFP), and the LN response to RT were significant prognostic factors for OS (p < 0.05 each). Based on the results of multivariate analysis, prognostic group stratification according to the number of pre-treatment risk factors was a significant predictor of OS, and median OS in patients with ≥ 4, 3, 2, 1, and 0 risk factors were 2.9, 5.5, 10.3, 13.6, and 27.8 months, respectively (p<0.05). A nomogram was formulated by integrating the different prognostic contribution of each factor, and it showed good accuracy for predicting 2-year OS with a concordance index of 0.72.
Conclusion: Prognostic group stratification and nomogram could be useful prognostic and therapeutic indicators in selecting treatment strategies.
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