Cancer Management and Research (Dec 2020)
Preoperative Combined Prediction Models Have Superior Capability in Predicting Survival as the Child-Pugh Grade in Patients with HCC after Interventional Embolotherapy
Abstract
Meng Qing Xu,1,* Jin Jin Dai,2,* Zhi Sheng Jiang,3 Fang Xu,1 Long Wang,1 Wen Jie Zhang,4 Zhi Guo Guo1 1Department of Gastroenterology, Suzhou Hospital of Anhui Medical University, Suzhou, Anhui 234000, People’s Republic of China; 2Department of Infection, Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, 234000, People’s Republic of China; 3Department of Cardiothoracic Surgery, Jinling Hospital, Nanjing 210000, People’s Republic of China; 4Department of Pathology, School of Medicine, Shihezi University, Shihezi, Xinjiang 832002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhi Guo GuoSuzhou Hospital of Anhui Medical University, Suzhou, Anhui 234000, People’s Republic of ChinaEmail [email protected]: It is of important clinical significance for hepatocellular carcinoma (HCC) patients to evaluate prognosis before interventional embolotherapy.Methods: A total of 106 patients with HCC after interventional embolotherapy who had complete data with follow-up information until September 2019 were included in this study. These data were analyzed using SPSS Version 22.0 and R (version 3.6.1) statistical software.Results: 1) The diameter of the tumor, ascites, FIT, AFP, ALT, AST, GGT, and Child–Pugh score had the ability to predict the prognosis and survival of patients with HCC. Among these molecules, the predictive effectiveness (or the area under the receiver operating characteristic [ROC] curve) of GGT was the highest, although it was slightly lower than the predictive effectiveness of the Child–Pugh score, which is the gold standard for survival analysis. 2) Among survival analyses combining five molecular indicators, the predictive postoperative viability for combination 1 was the strongest with an area under the ROC curve (AUC) of 0.856 (0.779, 0.932), similar to the all-molecular combination (combination 16) with an AUC of 0.872 (0.798, 0.945), but much higher than that of the Child–Pugh score of 0.720 (0.616, 0.823) for HCC patients (all p< 0.05). 3) Kaplan–Meier analyses showed that the 3-year cumulative survival rates were 55.3% for low-risk patients and 2.6% for high-risk patients.Conclusion: A combined prediction model can determine the optimal combination of preoperative routine detection indices in patients with HCC intervention, and ROC curve analysis can quantify the efficacy of these indices in the survival and prognosis of HCC. Interestingly, combination 1 showed stronger predictive capability than the Child–Pugh score in predicting death risks for postoperative patients with HCC. When combination 1 has several missing clinical data, these combination prediction models (12, 3, 7, 13, 16) are also a replaceable choice. These findings may have important clinical significance in the formulation of individualized medical programs.Keywords: hepatocellular carcinoma after interventional embolotherapy, preoperative combined prediction model, survival prognosis, death risk, Child–Pugh score
