A nomogram based on PNI and preoperative TACE can predict overall survival in patients with larger than 2 cm HCC after hepatectomy.

IF 2.4 3区医学 Q2 SURGERY

Updates in Surgery Pub Date : 2025-05-05 DOI:10.1007/s13304-025-02194-1

Huizhi Zhang, Chunyu Zhang, Run Hu, Kai Lei, Xingxing Wang, Zuojin Liu

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引用次数: 0

Abstract

This study was to construct a nomogram based on prognostic nutritional index (PNI) and preoperative transcatheter arterial chemoembolization (TACE) to predict the overall survival (OS) of patients with hepatocellular carcinoma (HCC) larger than 2 cm after hepatectomy. 307 and 131 patients were included in the development and validation sets, respectively. The clinical endpoint was OS. Univariate and multivariate Cox regression analyses were used in the development set to screen independent risk factors for clinical endpoints. Independent risk factors were used to construct a nomogram. The C-index, calibration curves, and decision analysis curves were used to evaluate the predictive power of the nomogram in the development and validation sets. After univariate and multivariate Cox regression analysis, independent risk factors for OS included preoperative TACE, age, Barcelona Clinic Liver Cancer (BCLC) stage, PNI, tumor longest diameter, and alpha-fetoprotein (AFP). In the development set and the validation set, the C-index of the nomograms was 0.662 (95% confidence interval (CI): 0.624-0.699) and 0.659 (95% CI: 0.600-0.719), respectively. Calibration curves and decision analysis curves showed that the nomogram had an effective predictive ability. The nomogram based on PNI and preoperative TACE can effectively predict the OS of patients with HCC larger than 2 cm after hepatectomy.

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基于PNI和术前TACE的nomogram预测肝切除术后大于2 cm HCC患者的总生存期。

本研究旨在构建基于预后营养指数（PNI）和术前经导管动脉化疗栓塞（TACE）的nomogram预测肝切除术后大于2cm的肝细胞癌（HCC）患者的总生存期（OS）。开发组和验证组分别纳入307例和131例患者。临床终点为OS。采用单因素和多因素Cox回归分析筛选临床终点的独立危险因素。使用独立危险因素构建nomogram。采用c指数、校正曲线和决策分析曲线来评价nomogram在开发集和验证集的预测能力。经单因素和多因素Cox回归分析，OS的独立危险因素包括术前TACE、年龄、巴塞罗那临床肝癌（BCLC）分期、PNI、肿瘤最长直径和甲胎蛋白（AFP）。在开发集和验证集，模态图的c指数分别为0.662（95%置信区间（CI）： 0.624-0.699）和0.659 （95% CI: 0.600-0.719）。标定曲线和决策分析曲线表明，该模态图具有有效的预测能力。基于PNI和术前TACE的nomogram可有效预测肝癌切除术后大于2cm患者的OS。

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

Updates in Surgery Medicine-Surgery

CiteScore

4.50

自引率

7.70%

发文量

208

期刊介绍： Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.