Open AccessNomogram predicting extrahepatic metastasis of hepatocellular carcinoma based on commonly available clinical data
Author(s) -
Lee ChernHorng,
Chang CheeJen,
Lin YuJr,
Yen ChoLi,
Shen ChienHeng,
Cheng YaTing,
Lin ChenChun,
Hsieh SenYung
Publication year - 2019
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12102
Subject(s) - nomogram , medicine , hepatocellular carcinoma , proportional hazards model , oncology , hazard ratio , confidence interval , concordance
Background and Aim Extrahepatic metastasis (EHM) of hepatocellular carcinoma (HCC) leads to a worse prognosis. We aimed to develop a nomogram based on noninvasive pretreatment clinical data to predict EHM of HCC sooner. Methods Three cohorts containing 1820, 479, and 988 HCC patients were enrolled from three hospitals in different regions in Taiwan and served as the training and validation cohorts. Pretreatment clinical data were analyzed by Cox regression modeling for independent risk factors of EHM. Results Platelet count ≥ 200 × 10 3 /μL, serum alfa‐fetoprotein ≥ 100 ng/dL, tumor size ≥ 3 cm, tumor number > 1, and macrovascular invasion were independent risk factors for EHM and were used to develop a nomogram. This nomogram had concordance indices of 0.733 (95% confidence interval [CI]: 0.688–0.778) and 0.739 (95% CI: 0.692–0.787) for the prediction of EHM during a 5‐year follow‐up duration in the training and validation cohorts, respectively. A nomogram score > 61 implied a high risk of EHM (hazard ratio [HR] = 3.83; 95% CI: 2.77–5.31, P < 0.001). Conclusion We have developed a nomogram that could accurately predict EHM of HCC and be readily available for formulating individualized treatment for all individual HCC patients to improve therapeutic efficacy.