Local tumor destruction and liver resection increase overall survival in intermediate/advanced hepatocellular carcinoma patients: evidence from a population-based study
- Zhang Y. [1] ,
- Zhang Y. [5] ,
- He T. [6] ,
- Liu G. [4] ,
- Duan M. [1] ,
- Huang J. [8] ,
- Huang C. [2] ,
- Lowe S. [3] ,
- Ke D. [5] ,
- Liu X. [4] and
- Cao J. [7]
Repository
Description
Background
Liver resection (LR) and local tumor destruction (LTD) are effective treatments, but not commonly recommended for patients with intermediate/advanced hepatocellular carcinoma (HCC). This study aimed to explore whether LR/LTD could improve overall survival (OS) of these patients, and to identify the patients who will most likely benefit from LR/LTD.
Methods
Data of patients with intermediate/advanced HCC between 2001 and 2018 were extracted from Surveillance, Epidemiology, and End Results database. OS was compared between HCC patients who received LR/LTD and those who did not. A nomogram was constructed for predicting OS, and it was then validated.
Results
A total of 535 eligible patients were included, among which 128 received LR/LTD while 407 did not. Significantly higher OS in patients who received LR/LTD was observed (P<0.001). Based on independent prognostic factors obtained from univariate and multivariate analyses, a nomogram was constructed. The C-indices of nomogram were higher than those of the TNM staging system (training cohort: 0.74 vs. 0.59; validation cohort: 0.78 vs. 0.61). Similarly, areas under receiver operating characteristic curves and calibration curves indicated good accuracy of the nomogram. Decision curve analysis curves revealed good clinical practicability of the nomogram. Furthermore, low-risk patients (nomogram score: 0-221.9) had higher OS compared with high-risk patients (nomogram score: higher than 221.9) (P<0.001).
Conclusion
LR/LTD significantly improves OS in patients with intermediate/advanced HCC. The nomogram developed in the present study shows high predicating value for OS in patients with intermediate/advanced HCC, which might be useful in selecting patients who are most suitable for LR/LTD.
Subjects
Affiliations
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.
- College of Osteopathic Medicine, California Health Sciences University, Clovis, CA, United States.
- College of Osteopathic Medicine, Kansas City University, Kansas, MO, United States.
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
- Department of Medical Quality Control, The First People's Hospital of Zigong City, Zigong, China.
- Graduate School, Guangxi University of Chinese Medicine, Nanning, China.