中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

Establishment of a nomogram for survival rate after liver resection for primary small hepatocellular carcinoma based on SEER data and external validation

DOI: 10.3969/j.issn.1001-5256.2022.01.017
Research funding:

Sichuan Science and Technology Program Project (2018JY0489);

Sichuan Education Department Scientific Research Project (18ZB0217);

Sichuan Health Care Commission Popular Application Project (20PJYY2695);

North Sichuan Medical College Scientific Research Project (CBY18-A-YB37)

  • Received Date: 2021-06-09
  • Accepted Date: 2021-06-29
  • Published Date: 2022-01-20
  •   Objective  To establish a nomogram for overall survival rate after liver resection for primary small hepatocellular carcinoma based on SEER data and external validation of Chinese data.  Methods  The data of 1809 patients, registered in National Cancer Institute SEER database in 2004-2015, who underwent hepatectomy for primary small hepatocellular carcinoma were extracted as modeling group, and 158 patients with small hepatocellular carcinoma who underwent hepatectomy in Affiliated Hospital of North Sichuan Medical College from 2010 to 2017 were collected as validation group. The univariate Cox risk regression analysis, lasso regression analysis, and multivariate Cox hazard regression analysis were used to investigate the influencing factors for OS after hepatectomy in patients with small hepatocellular carcinoma. A nomogram was established based on the independent influencing factors for OS, and index of concordance (C-index), calibration curves, and receiver operating characteristic (ROC) curve were used to analyze the predictive ability of the nomogram. The Kaplan-Meier survival analysis and the log-rank test were used to investigate the difference in survival between the high- and low-risk groups.  Results  The multivariate Cox hazard regression analysis showed that sex (hazard ratio [HR]=1.22, 95% confidence interval [CI]: 1.05-1.41, P=0.010), Seer stage (HR=1.51, 95%CI: 1.23-1.85, P < 0.001; HR=10.31, 95%CI: 2.53-42.04, P=0.001), tumor diameter (HR=1.22, 95%CI: 1.06-1.39, P=0.004), vascular invasion or metastasis (HR=1.43, 95%CI: 1.24-1.65, P < 0.001), and alpha-fetoprotein (HR=1.33, 95%CI: 1.16-1.54, P < 0.001) were independent risk factors for OS after hepatectomy for small hepatocellular carcinoma. The modeling group had a C-index of 0.621, and its area under the ROC curve at 1, 2, and 3 years was 0.666(95%CI 0.628-0.704), 0.678(95%CI 0.647-0.708), and 0.663(95%CI: 0.635-0.690), respectively; the validation group had a C-index of 0.718, and its area under the ROC curve at 1, 2, and 3 years was 0.695(95%CI: 0.593-0.797), 0.781(95%CI: 0.706-0.856), and 0.759(95%CI 0.669-0.848), respectively. Risk stratification was performed based on the nomogram, and the Kaplan-Meier survival analysis showed that for both the modeling group and the validation group, the low-risk group had a significantly better prognosis than the high-risk group (P < 0.01).  Conclusion  The model established for survival rate after liver resection for primary small hepatocellular carcinoma can predict the 1-, 2-, and 3-year OS rates and can thus be used in clinical practice in China.

     

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    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 6.9 %其他: 6.9 %其他: 0.9 %其他: 0.9 %Canada: 0.1 %Canada: 0.1 %Central District: 0.4 %Central District: 0.4 %China: 1.1 %China: 1.1 %India: 0.6 %India: 0.6 %United States: 0.1 %United States: 0.1 %[]: 0.2 %[]: 0.2 %三明: 0.1 %三明: 0.1 %上海: 2.6 %上海: 2.6 %上饶: 0.1 %上饶: 0.1 %东京: 0.2 %东京: 0.2 %东京都: 0.1 %东京都: 0.1 %东莞: 0.5 %东莞: 0.5 %中卫: 0.2 %中卫: 0.2 %中山: 0.1 %中山: 0.1 %丽水: 0.1 %丽水: 0.1 %乐山: 0.1 %乐山: 0.1 %佛山: 0.2 %佛山: 0.2 %保定: 0.1 %保定: 0.1 %信阳: 0.5 %信阳: 0.5 %六安: 0.1 %六安: 0.1 %内江: 0.1 %内江: 0.1 %凉山彝族自治州: 0.1 %凉山彝族自治州: 0.1 %北京: 4.9 %北京: 4.9 %南京: 0.7 %南京: 0.7 %南充: 1.5 %南充: 1.5 %南宁: 0.1 %南宁: 0.1 %南平: 0.3 %南平: 0.3 %南昌: 0.4 %南昌: 0.4 %南通: 0.3 %南通: 0.3 %南阳: 0.1 %南阳: 0.1 %卡纳塔克: 0.1 %卡纳塔克: 0.1 %印多尔: 0.1 %印多尔: 0.1 %厦门: 0.2 %厦门: 0.2 %台州: 0.2 %台州: 0.2 %合肥: 0.1 %合肥: 0.1 %吉林: 0.2 %吉林: 0.2 %吕梁: 0.1 %吕梁: 0.1 %呼和浩特: 0.2 %呼和浩特: 0.2 %哈尔滨: 0.1 %哈尔滨: 0.1 %哥伦布: 0.1 %哥伦布: 0.1 %嘉兴: 0.1 %嘉兴: 0.1 %四平: 0.1 %四平: 0.1 %大连: 0.1 %大连: 0.1 %天津: 0.4 %天津: 0.4 %太原: 0.1 %太原: 0.1 %威海: 0.1 %威海: 0.1 %孝感: 0.1 %孝感: 0.1 %宁德: 0.1 %宁德: 0.1 %安康: 0.1 %安康: 0.1 %安顺: 0.1 %安顺: 0.1 %宜春: 0.1 %宜春: 0.1 %宿州: 0.1 %宿州: 0.1 %巴中: 0.1 %巴中: 0.1 %巴音郭楞: 0.1 %巴音郭楞: 0.1 %常德: 0.1 %常德: 0.1 %广州: 1.4 %广州: 1.4 %张家口: 9.9 %张家口: 9.9 %怀化: 0.1 %怀化: 0.1 %成都: 1.2 %成都: 1.2 %扬州: 0.1 %扬州: 0.1 %无锡: 0.2 %无锡: 0.2 %昆明: 0.3 %昆明: 0.3 %晋城: 0.1 %晋城: 0.1 %杭州: 1.5 %杭州: 1.5 %格兰特县: 0.1 %格兰特县: 0.1 %桂林: 0.2 %桂林: 0.2 %武汉: 0.8 %武汉: 0.8 %汕头: 0.1 %汕头: 0.1 %江门: 0.1 %江门: 0.1 %池州: 0.2 %池州: 0.2 %沈阳: 0.2 %沈阳: 0.2 %河池: 0.1 %河池: 0.1 %泰安: 0.1 %泰安: 0.1 %泸州: 0.1 %泸州: 0.1 %洛阳: 0.1 %洛阳: 0.1 %济南: 0.1 %济南: 0.1 %海口: 0.2 %海口: 0.2 %海得拉巴: 0.3 %海得拉巴: 0.3 %淄博: 0.1 %淄博: 0.1 %淮南: 0.1 %淮南: 0.1 %淮安: 0.1 %淮安: 0.1 %深圳: 0.4 %深圳: 0.4 %温州: 0.4 %温州: 0.4 %湖州: 0.1 %湖州: 0.1 %湘潭: 0.1 %湘潭: 0.1 %湛江: 0.1 %湛江: 0.1 %漳州: 0.2 %漳州: 0.2 %潍坊: 0.1 %潍坊: 0.1 %烟台: 0.2 %烟台: 0.2 %白银: 0.1 %白银: 0.1 %盐城: 0.3 %盐城: 0.3 %石家庄: 0.2 %石家庄: 0.2 %绍兴: 0.1 %绍兴: 0.1 %绵阳: 0.1 %绵阳: 0.1 %罗莫朗坦朗特奈: 0.1 %罗莫朗坦朗特奈: 0.1 %自贡: 0.2 %自贡: 0.2 %舟山: 0.1 %舟山: 0.1 %芒廷维尤: 26.8 %芒廷维尤: 26.8 %芜湖: 0.1 %芜湖: 0.1 %芝加哥: 0.5 %芝加哥: 0.5 %苏州: 0.4 %苏州: 0.4 %莆田: 0.1 %莆田: 0.1 %莫斯科: 2.3 %莫斯科: 2.3 %菲尼克斯: 0.1 %菲尼克斯: 0.1 %葫芦岛: 0.2 %葫芦岛: 0.2 %蚌埠: 0.1 %蚌埠: 0.1 %衢州: 0.3 %衢州: 0.3 %襄阳: 0.1 %襄阳: 0.1 %西孟加拉邦: 0.1 %西孟加拉邦: 0.1 %西宁: 16.1 %西宁: 16.1 %西安: 0.2 %西安: 0.2 %贵阳: 0.1 %贵阳: 0.1 %赤峰: 0.1 %赤峰: 0.1 %辽阳: 0.1 %辽阳: 0.1 %运城: 1.1 %运城: 1.1 %连云港: 0.1 %连云港: 0.1 %郑州: 0.3 %郑州: 0.3 %重庆: 0.6 %重庆: 0.6 %银川: 0.1 %银川: 0.1 %锦州: 0.2 %锦州: 0.2 %镇江: 0.1 %镇江: 0.1 %长春: 0.7 %长春: 0.7 %长沙: 0.9 %长沙: 0.9 %长治: 0.1 %长治: 0.1 %阜阳: 0.1 %阜阳: 0.1 %随州: 0.2 %随州: 0.2 %青岛: 0.1 %青岛: 0.1 %鞍山: 0.1 %鞍山: 0.1 %马尼拉: 0.1 %马尼拉: 0.1 %驻马店: 0.1 %驻马店: 0.1 %鹰潭: 0.1 %鹰潭: 0.1 %黄冈: 0.1 %黄冈: 0.1 %黄南: 0.1 %黄南: 0.1 %龙岩: 0.1 %龙岩: 0.1 %其他其他CanadaCentral DistrictChinaIndiaUnited States[]三明上海上饶东京东京都东莞中卫中山丽水乐山佛山保定信阳六安内江凉山彝族自治州北京南京南充南宁南平南昌南通南阳卡纳塔克印多尔厦门台州合肥吉林吕梁呼和浩特哈尔滨哥伦布嘉兴四平大连天津太原威海孝感宁德安康安顺宜春宿州巴中巴音郭楞常德广州张家口怀化成都扬州无锡昆明晋城杭州格兰特县桂林武汉汕头江门池州沈阳河池泰安泸州洛阳济南海口海得拉巴淄博淮南淮安深圳温州湖州湘潭湛江漳州潍坊烟台白银盐城石家庄绍兴绵阳罗莫朗坦朗特奈自贡舟山芒廷维尤芜湖芝加哥苏州莆田莫斯科菲尼克斯葫芦岛蚌埠衢州襄阳西孟加拉邦西宁西安贵阳赤峰辽阳运城连云港郑州重庆银川锦州镇江长春长沙长治阜阳随州青岛鞍山马尼拉驻马店鹰潭黄冈黄南龙岩

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