Research Paper Volume 12, Issue 12 pp 11878—11892
Development and validation of a risk score for predicting mortality after resection of primary hepatocellular carcinoma
- 1 Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- 2 Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- 3 Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
Received: December 13, 2019 Accepted: May 20, 2020 Published: June 21, 2020
https://doi.org/10.18632/aging.103360How to Cite
Copyright © 2020 Zhou et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Primary hepatocellular carcinoma (PHCC) has a poor prognosis and high short-term mortality rate, even after resection. Thus, early diagnosis in PHCC cases can help improve quality of life via personalized management strategies.
Results: The risk score system (RSS) were classified as low risk (<5 points), medium risk (5–10 points), or high risk (>10 points). The areas under the receiver operating characteristic curves were 0.80 in the training cohort and 0.69 in the validation cohort, which indicated satisfactory prognostic performance. The Hosmer-Lemeshow goodness of fit test (P>0.05) revealed consistent performance in both groups. The concordance index (C-index: 0.663, 95% CI: 0.618–0.708) revealed excellent discrimination and good calibration in the validation cohort.
Conclusions: This simple RSS, which is based on clinical and laboratory data from patients undergoing resection of PHCC, might allow clinicians and medical staff to better manage PHCC.
Materials and Methods: A total of 672 PHCC cases were retrospectively obtained from the First Affiliated Hospital of Wenzhou Medical University between January 2007 and February 2015. Cox proportional hazard models were used to identify independent predictors of mortality. Kaplan-Meier curves and the log-rank test were used to examine the relationships between the prognostic factors and overall mortality.
Abbreviations
PHCC: primary hepatocellular carcinoma; HCC: hepatocellular carcinoma; HBV: Hepatitis B virus; TNM: Tumor-Node-Metastasis; CLIP: Cancer of the Liver Italian Program; BCLC: Barcelona Clinic Liver Cancer; BMI: body mass index; AFP: alpha fetoprotein; PT: prothrombin time; FIB: fibrinogen; PLT: platelet; ALB: albumin; TBIL: total bilirubin; TC: total cholesterol; ALT: alanine transaminase; AST: aspartate transaminase; γ-GT: γ-glutamyl transpeptidase; LNM: lymph node metastasis; MVI: microvascular invasion; PVTT: portal vein tumor thrombus; IATO: invasion of adjacent tissue or organ; C-index: concordance index; ROC: receiver operating characteristics; AUC: area under curve; CI: confidence interval; OS: overall survival.