Nomograms of Li et al for Survival After Resection of a Huge Hepatocellular Carcinoma: Preoperative 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 (>= 9.5 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) serum AFP in µg/L

(2) HBV-DNA level in IU/mL

(3) number of tumors on imaging studies

(4) tumor diameter on imaging studies (presumably the larger or largest if more than one tumor present)

(5) portal vein tumor thrombosis (PVTT) on imaging

Parameter	Finding	Points
serum AFP	<= 200 µg/L	0
	> 200 µg/L	26
HBV DNA level	<= 10^4 IU/mL	0
	> 10^4 to <= 10^6 IU/mL	39
	> 10^6 IU/mL	49
number of tumors	1	0
	2	40
	>= 3	83
PVTT	no	0
	yes	100

diameter	Points
< 9.5	NA
9.5 to 19	(0.6571 * ((diameter)^2)) – (7.128 * (diameter)) – 1.09
> 19	97

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 355

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

Parameter	Finding
< 24	> 65%
24 to 147	76.32 – (0.5047 * (points))
> 147	< 5%

Performance:

• The area under the ROC curve ranged from 0.67 to 0.75.

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

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