Journal of Hepatocellular Carcinoma (Aug 2022)

Nomogram for the Preoperative Prediction of the Macrotrabecular-Massive Subtype of Hepatocellular Carcinoma

  • Shan Y,
  • Yu X,
  • Yang Y,
  • Sun J,
  • Wu S,
  • Mao S,
  • Lu C

Journal volume & issue
Vol. Volume 9
pp. 717 – 728

Abstract

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Yuying Shan, Xi Yu, Yong Yang, Jiannan Sun, Shengdong Wu, Shuqi Mao, Caide Lu Department of Hepatopancreatobiliary Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315041, People’s Republic of ChinaCorrespondence: Caide Lu; Shuqi Mao, Department of Hepatopancreatobiliary Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315041, People’s Republic of China, Email [email protected]; [email protected]: The macrotrabecular-massive subtype of hepatocellular carcinoma (MTM-HCC) is an aggressive histological type and results in poor prognosis. We developed a nomogram model based on laboratory results to predict the presence of MTM-HCC.Methods: A total of 357 HCC patients who underwent radical surgery between January 2015 and December 2020 at Ningbo Medical Center Lihuili Hospital were grouped according to histological type. After propensity score matching (PSM), 267 patients were divided into MTM-HCC (n = 76) and non-MTM-HCC (n = 191) groups. A LASSO regression analysis model was used to select predictive factors. Finally, a nomogram for predicting the presence of MTM-HCC was established. Decision curve analysis (DCA) was conducted to determine the clinical usefulness of the nomogram model by quantifying the net benefits along with the increase in threshold probabilities.Results: The 1-, 3-, and 5-year disease-free survival (DFS) and overall survival (OS) rates for MTM-HCC were 60.0%, 36.0%, 32.4% and 92.1%, 68.7%, 52.2%, respectively. Survival analysis indicated that the probabilities of achieving DFS and OS were significantly worse in the MTM-HCC group than in the non-MTM-HCC group (P < 0.05). The nomogram model that included AST levels, PT and AFP levels achieved a better C-index of 0.723 (95% CI: 0.659– 0.787). DCA revealed that the nomogram model could lead to net benefits and exhibited a wider range of threshold probabilities in the prediction of MTM-HCC.Conclusion: The nomogram model included AST, PT and AFP could achieve an optimal performance in the preoperative prediction of MTM-HCC.Keywords: hepatocellular carcinoma, macrotrabecular-massive subtype, prognosis, nomogram, aggressiveness

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