Nomograms of Li et al for Survival After Resection of a Huge Hepatocellular Carcinoma: Postoperative Model

Description

Li et al developed nomograms for predicting survival before and after surgical resection of a huge hepatocellular carcinoma. This can help to identify a patient who may benefit from more aggressive management. The authors are from Mengchao Hepatobiliary Surgery Hospital, Fujian Medical University, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University and the Chinese University of Hong Kong.

Patient selection: resection of a huge hepatoceellular carcinoma (>= 10 cm).

Criteria for resection: Child-Pugh grade A, good general condition, no or only mild cirrhosis, no intra or extra-hepatic metastases

Outcome: long-term survival (4 years)

Parameters:

(1) HBV-DNA level in IU/mL

(2) number of tumors on pathologic exam

(3) tumor diameter on pathologic exam (presumably the larger or largest if more than one tumor present)

(4) vascular invasion

(5) capsule

(6) Edmonson-Steiner classification

Parameter	Finding	Points
HBV DNA level	<= 10^4 IU/mL	0
	> 10^4 to <= 10^6 IU/mL	24
	> 10^6 IU/mL	36
number of tumors	1	0
	2	31
	>= 3	64
vascular invasion	no	0
	microscopic	34
	macroscopic	100
capsule	complete	0
	incomplete	32
Edmonson-Steiner grade	I or II	0
	III or IV	42

diameter	Points
< 10	NA
10 to 19	(0.6997 * ((diameter)^2)) – (8.935 * (diameter)) + 14.84
> 19	97

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 378

• The higher the score the worse the 4-year survival.

Parameter	Finding
< 80	> 65%
80 to 190	109.6 – (0.5654 * (points))
> 190	< 5%

Performance:

• The area under the ROC curve ranged from 0.78.

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Nomograms of Li et al for Survival After Resection of a Huge Hepatocellular Carcinoma: Postoperative Model

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