Open AccessDevelopment and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation
Author(s) -
Kim Chang Gon,
Lee Hyun Woong,
Choi Hye Jin,
Lee Jung Il,
Lee Hye Won,
Kim Seung Up,
Park Jun Yong,
Kim Do Young,
Ahn Sang Hoon,
Han KwangHyub,
Kim Han Sang,
Kim Kyung Hwan,
Choi Seong Jin,
Kim Yongun,
Lee Kwan Sik,
Kim Gyoung Min,
Kim Man Deuk,
Won Jong Yoon,
Lee Do Yun,
Kim Beom Kyung
Publication year - 2019
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2417
Subject(s) - nomogram , medicine , cohort , radiofrequency ablation , hepatocellular carcinoma , hazard ratio , proportional hazards model , confidence interval , concordance , radiology , oncology , ablation
Background There are large variations in prognosis among hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA). However, current staging or scoring systems hardly discriminate the outcome of HCC patients treated with RFA. Methods A total of 757 treatment‐naïve HCC patients undergoing RFA (derivation cohort) were analyzed to establish a nomogram for disease‐free survival (DFS) based on Cox proportional hazard regression model. Accuracy of the nomogram was assessed and compared with conventional staging or scoring systems. Furthermore, external validation was performed in an independent cohort including 208 patients (validation cohort). Results Tumor size, tumor number, alpha‐fetoprotein, prothrombin induced by vitamin K absence‐II, lymphocyte count, albumin, and presence of ascites were adopted to construct the prognostic nomogram from the derivation cohort. Calibration curves to predict probability of DFS at 3 and 5 years after RFA showed good agreements between the nomogram and actual observations. The concordance index of the present nomogram was 0.759 (95% confidence interval 0.728‐0.790), which was superior to those of conventional staging or scoring systems (range 0.505‐0.683, all P < .001). These results were also reproduced in the validation cohort. Conclusion Our simple‐to‐use nomogram optimized for treatment‐naïve HCC patients undergoing RFA provided better prognostic performance than conventional staging or scoring systems.