Background: The aim of this study was to combine clinicopathologic variables associated with overall survival and disease-free survival after curative resection for hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT) into a prediction nomogram.
Methods: We retrospectively analysed 358 patients who underwent curative resection for HCC with PVTT at the Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, China. Two-thirds of the patients were randomly assigned to the training set (n = 252) and one-third were assigned to the validation set (n = 106). Multivariate analysis by Cox proportional hazards regression was performed using the training set, and the nomogram was constructed. Discrimination and calibration were performed using the validation set.
Results: The multivariate Cox model identified alpha fetoprotein, hepatitis B surface antigen (HBsAg), tumour diameter, tumour capsule, PVTT type and TNM stage as covariates associated with 1-year survival, and alpha fetoprotein, HBsAg, tumour diameter, tumour capsule and PVTT type with half-year disease-free survival. In the validation set, the nomogram exhibited superior discrimination power (Harrell's C-index 0.78) compared with the American Joint Committe on Cancer TNM classification, the Cancer of the Liver Italian Program grade and the Japan Integrated Staging grade. Calibration of the nomogram-predicted survival corresponding closely with the actual survival, the predicted survival was within a 10% margin of ideal nomogram.
Conclusion: We developed a nomogram predicting 1-year overall survival and half-year disease-free survival after curative resection for HCC with PVTT. Validation data sets revealed good discrimination and calibration, suggesting good clinical utility. The nomogram improved individualized predictions of survival.
Keywords: HCC with PVTT; disease-free survival; nomogram; overall survival; predicting model.
© 2018 Royal Australasian College of Surgeons.