A nomogram to predict survival of patients with intermediate-stage hepatocellular carcinoma after transarterial chemoembolization combined with microwave ablation.

Objectives: To develop a prognostic nomogram based on the albumin-bilirubin (ALBI) grade for prediction of the long-term survival of patients with intermediate-stage hepatocellular carcinoma (HCC) after transarterial chemoembolization combined with microwave ablation (TACE-MWA).Methods: We retrospec...

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Published in:European Radiology Vol. 30; no. 4; pp. 2377 - 2391
Main Authors: Ni, Jia-yan, Fang, Zhu-ting, Sun, Hong-liang, An, Chao, Huang, Zhi-mei, Zhang, Tian-qi, Jiang, Xiong-ying, Chen, Yao-ting, Xu, Lin-feng, Huang, Jin-hua
Format: research Journal Article
Published: Springer Nature Apr2020
Online Access:View this record in EBSCOhost
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      dt: Apr2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-019-06438-8
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        atl: A nomogram to predict survival of patients with intermediate-stage hepatocellular carcinoma after transarterial chemoembolization combined with microwave ablation.
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          Ni, Jia-yan
          Fang, Zhu-ting
          Sun, Hong-liang
          An, Chao
          Huang, Zhi-mei
          Zhang, Tian-qi
          Jiang, Xiong-ying
          Chen, Yao-ting
          Xu, Lin-feng
          Huang, Jin-hua
        affil: Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Cancer for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, Guangdong Province, People's Republic of China
      sug:
        subj:
          Neoplasm Staging Methods
          Carcinoma, Hepatocellular Therapy
          Liver Neoplasms Therapy
          Models, Statistical
          Microwaves Therapeutic Use
          Chemoembolization, Therapeutic Methods
          Magnetic Resonance Imaging
          Female
          Aged
          Adolescence
          Carcinoma, Hepatocellular Diagnosis
          Treatment Outcomes
          Retrospective Design
          Middle Age
          Young Adult
          Adult
          Human
          Tomography, X-Ray Computed
          Prognosis
          Male
          Liver Neoplasms Diagnosis
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Funding Source
          Aged: 65+ years
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
          Male
      ab: Objectives: To develop a prognostic nomogram based on the albumin-bilirubin (ALBI) grade for prediction of the long-term survival of patients with intermediate-stage hepatocellular carcinoma (HCC) after transarterial chemoembolization combined with microwave ablation (TACE-MWA).Methods: We retrospectively studied 546 consecutive patients with intermediate-stage HCC according to the Barcelona Clinic Liver Cancer guidelines who underwent TACE-MWA between January 2000 and December 2016. Overall survival (OS) and progression-free survival (PFS) were analyzed. The predictive value of the ALBI grade was investigated. The prognostic nomogram was constructed using the independent predictors assessed by the multivariate Cox proportional hazards model.Results: After a median follow-up of 35.0 months (range, 4.0-221.0 months), 380 patients had died. The median OS was 35.0 months (95% confidence interval (CI), 30.84-39.16 months), and the median PFS was 6.5 months (95% CI, 6.13-6.87 months). The ALBI grade was validated as an independent predictor of OS (p < 0.001). Multivariate analyses showed that Eastern Cooperative Oncology Group performance status score more than 0, presence of liver cirrhosis, a-fetoprotein level above 400 ng/mL, tumor size greater than 5 cm, tumor number more than 3, advanced ALBI grade, and treatment sessions of TACE or MWA fewer than 3 were independently associated with overall mortality. The prognostic nomogram incorporating these eight predictors achieved good calibration and discriminatory abilities with a concordance index of 0.770 (95% CI, 0.746-0.795).Conclusions: The prognostic nomogram based on the ALBI grade resulted in reliable efficacy for prediction of individualized OS in patients with intermediate-stage HCC after TACE-MWA.Key Points: • TACE-MWA was associated with a median overall survival of 35.0 months for patients with intermediate-stage HCC. • A prognostic nomogram was built to predict individualized survival of patients with intermediate-stage HCC after TACE-MWA. • The prognostic nomogram incorporating eight predictors achieved good calibration and discriminatory abilities with a concordance index of 0.770.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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