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Development and validation of nomogram to predict overall survival and disease-free survival after surgical resection in elderly patients with hepatocellular carcinoma

  • 0Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Frontiers in Oncology +

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June 10, 2024

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June 10, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

This study developed a nomogram to predict survival and recurrence in elderly patients with hepatocellular carcinoma (HCC) after surgery. The tool shows good predictive value, aiding in individualized treatment strategies for HCC patients.

Area Of Science

  • Oncology
  • Geriatric Medicine
  • Surgical Oncology

Background

  • Hepatocellular carcinoma (HCC) is a significant cause of cancer-related mortality in the elderly population.
  • Current prognostic predictors lack individualization for elderly HCC patients post-surgery.

Purpose Of The Study

  • To identify independent prognostic factors for overall survival (OS) and disease-free survival (DFS) in elderly HCC patients undergoing hepatectomy.
  • To construct and validate a predictive nomogram for OS and DFS in this patient cohort.

Main Methods

  • Retrospective analysis of 188 elderly HCC patients who underwent hepatectomy.
  • Utilized univariate Cox regression, LASSO, and multivariate Cox regression to identify prognostic indicators.
  • Developed and validated a nomogram using ROC curves, calibration curves, C-index, and DCA.

Main Results

  • Identified key predictors for OS (albumin, cancer embolus, blood loss, viral hepatitis B, total bilirubin, microvascular invasion, overweight, major resection) and DFS (major resection, albumin, microvascular invasion, laparoscopic surgery, blood loss, total bilirubin, pleural effusion).
  • The nomogram demonstrated strong predictive accuracy in both training (OS: 0.827, DFS: 0.739) and validation (OS: 0.798, DFS: 0.694) cohorts.
  • Nomogram performance surpassed T-staging according to C-index and DCA.

Conclusions

  • The developed nomogram effectively predicts OS and DFS in elderly HCC patients post-hepatectomy.
  • The nomogram's good calibration and predictive efficacy suggest clinical feasibility for individualized patient management.
  • Key predictors include cancer embolus, viral hepatitis B, overweight, major resection, albumin, microvascular invasion, laparoscopic surgery, blood loss, total bilirubin, and pleural effusion.

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