Risk Models for Predicting the Recurrence and Survival in Patients With Hepatocellular Carcinoma Undergoing Radio-Frequency Ablation.

IF 1.9 4区医学 Q3 ONCOLOGY

Clinical Medicine Insights-Oncology Pub Date : 2024-02-07 eCollection Date: 2024-01-01 DOI:10.1177/11795549231225409

Jilin Yang, Lifeng Cui, Wenjian Zhang, Zexin Yin, Shiyun Bao, Liping Liu

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引用次数: 0

Abstract

Background: Hepatocellular carcinoma (HCC) patients have a poor prognosis after radio-frequency ablation (RFA), and investigating the risk factors affecting RFA and establishing predictive models are important for improving the prognosis of HCC patients.

Methods: Patients with HCC undergoing RFA in Shenzhen People's Hospital between January 2011 and December 2021 were included in this study. Using the screened independent influences on recurrence and survival, predictive models were constructed and validated, and the predictive models were then used to classify patients into different risk categories and assess the prognosis of different categories.

Results: Cox regression model indicated that cirrhosis (hazard ratio [HR] = 1.65), alpha-fetoprotein (AFP) ⩾400 ng/mL (HR = 2.03), tumor number (multiple) (HR = 2.11), tumor diameter ⩾20 mm (HR = 2.30), and platelets (PLT) ⩾ 244 (10⁹/L) (HR = 2.37) were independent influences for recurrence of patients after RFA. On the contrary, AFP ⩾400 ng/mL (HR = 2.48), tumor number (multiple) (HR = 2.52), tumor diameter ⩾20 mm (HR = 2.25), PLT ⩾244 (10⁹/L) (HR = 2.36), and hemoglobin (HGB) ⩾120 (g/L) (HR = 0.34) were regarded as independent influences for survival. The concordance index (C-index) of the nomograms for predicting disease-free survival (DFS) and overall survival (OS) was 0.727 (95% confidence interval [CI] = 0.770-0.684) and 0.770 (95% CI = 0.821-7.190), respectively. The prognostic performance of the nomograms was significantly better than other staging systems by analysis of the time-dependent C-index and decision curves. Each patient was scored using nomograms and influencing factors, and patients were categorized into low-, intermediate-, and high-risk groups based on their scores. In the Kaplan-Meier survival curve, DFS and OS were significantly better in the low-risk group than in the intermediate- and high-risk groups.

Conclusions: The 2 prediction models created in this work can effectively predict the recurrence and survival rates of HCC patients following RFA.

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预测接受射频消融术的肝细胞癌患者复发和存活率的风险模型

背景：肝细胞癌（HCC）患者射频消融（RFA）后预后较差，研究影响RFA的风险因素并建立预测模型对改善HCC患者的预后具有重要意义：研究纳入了2011年1月至2021年12月在深圳市人民医院接受RFA治疗的HCC患者。利用筛选出的复发和生存的独立影响因素，构建并验证预测模型，然后利用预测模型将患者分为不同的风险类别，并评估不同类别的预后：Cox回归模型显示，肝硬化（危险比[HR] = 1.65）、甲胎蛋白（AFP）⩾400 ng/mL（HR = 2.03）、肿瘤数目（多个）（HR = 2.11）、肿瘤直径⩾20 mm（HR = 2.30）和血小板（PLT）⩾ 244 (109/L)（HR = 2.37）是RFA术后患者复发的独立影响因素。相反，AFP ⩾400 ng/mL (HR = 2.48)、肿瘤数目（多个）（HR = 2.52）、肿瘤直径 ⩾20 mm (HR = 2.25)、PLT ⩾244 (109/L) (HR = 2.36)和血红蛋白 (HGB) ⩾120 (g/L) (HR = 0.34)被认为是生存率的独立影响因素。预测无病生存期（DFS）和总生存期（OS）的提名图一致性指数（C-index）分别为 0.727（95% 置信区间 [CI] = 0.770-0.684）和 0.770（95% CI = 0.821-7.190）。通过分析随时间变化的C指数和决策曲线，提名图的预后效果明显优于其他分期系统。使用提名图和影响因素对每位患者进行评分，并根据评分将患者分为低危、中危和高危组。在 Kaplan-Meier 生存曲线中，低风险组的 DFS 和 OS 明显优于中风险组和高风险组：结论：本研究建立的两个预测模型可以有效预测RFA术后HCC患者的复发率和生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Medicine Insights-Oncology Medicine-Oncology

CiteScore

2.40

自引率

4.50%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological topics. Of particular but not exclusive importance are molecular biology, clinical interventions, controlled trials, therapeutics, pharmacology and drug delivery, and techniques of cancer surgery. The journal welcomes unsolicited article proposals.