A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma
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Authors
Hsu, Chia-Yang
Liu, Po-Hong
Hsia, Cheng-Yuan
Lee, Yun-Hsuan
Nagaria, Teddy S.
Lee, Rheun-Chuan
Ho, Shu-Yein
Hou, Ming-Chih
Huo, Teh-Ia
Issue Date
2017
Type
Article
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Abstract
The nomogram of the Barcelona Clinic Liver Cancer (BCLC) has accurate outcome prediction. This study aims to propose a treatment-integrated nomogram derived from BCLC for patients with hepatocellular carcinoma (HCC). A total of 3,371 patients were randomly grouped into derivation (n = 2,247) and validation (n = 1,124) sets. Multivariate Cox proportional hazards model was used to generate the nomogram from tumor burden, cirrhosis, performance status (PS) and primary anti-cancer treatments. Concordance indices and calibration plots were used to evaluate the performance of nomogram. The derivation and validation sets had the same concordance index of 0.774 (95% confidence intervals: 0.717-0.826 and 0.656-0.874, respectively). In calibration plots, survival distributions predicted by the nomogram and observed by the Kaplan-Meier method were similar at 3- and 5-year for patients from derivation and validation sets. Validation group patients divided into 10 subgroups by the original and new treatment-integrated BCLC nomogram were used to evaluate the prognostic performance of integrating primary anti-cancer treatments. Compared to the nomogram of original BCLC system, the treatment-integrated nomogram of BCLC system had larger linear trend and likelihood ratio X-2. In conclusion, based on the results of concordance index tests, integrating primary anti-cancer treatments into the BCLC system provides similar discriminatory ability.
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Citation
Hsu, C.-Y., Liu, P.-H., Hsia, C.-Y., Lee, Y.-H., Nagaria, T. S., Lee, R.-C., … Huo, T.-I. (2017). A New Treatment-integrated Prognostic Nomogram of the Barcelona Clinic Liver Cancer System for Hepatocellular Carcinoma. Scientific Reports, 7(1). doi:10.1038/s41598-017-08382-3
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Creative Commons Attribution 4.0 International
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ISSN
2045-2322