Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation

Chang Gon Kim, Hyun Woong Lee, Hye Jin Choi, Jung Il Lee, Hye Won Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Han Sang Kim, Kyung Hwan Kim, Seong Jin Choi, Yongun Kim, Kwan Sik Lee, Gyoung Min Kim, Man Deuk Kim, Jong Yoon Won, Do Yun Lee, Beom Kyung Kim

Research output: Contribution to journalArticle

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Abstract

Background: There are large variations in prognosis among hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA). However, current staging or scoring systems hardly discriminate the outcome of HCC patients treated with RFA. Methods: A total of 757 treatment-naïve HCC patients undergoing RFA (derivation cohort) were analyzed to establish a nomogram for disease-free survival (DFS) based on Cox proportional hazard regression model. Accuracy of the nomogram was assessed and compared with conventional staging or scoring systems. Furthermore, external validation was performed in an independent cohort including 208 patients (validation cohort). Results: Tumor size, tumor number, alpha-fetoprotein, prothrombin induced by vitamin K absence-II, lymphocyte count, albumin, and presence of ascites were adopted to construct the prognostic nomogram from the derivation cohort. Calibration curves to predict probability of DFS at 3 and 5 years after RFA showed good agreements between the nomogram and actual observations. The concordance index of the present nomogram was 0.759 (95% confidence interval 0.728-0.790), which was superior to those of conventional staging or scoring systems (range 0.505-0.683, all P <.001). These results were also reproduced in the validation cohort. Conclusion: Our simple-to-use nomogram optimized for treatment-naïve HCC patients undergoing RFA provided better prognostic performance than conventional staging or scoring systems.

Original languageEnglish
Pages (from-to)5023-5032
Number of pages10
JournalCancer medicine
Volume8
Issue number11
DOIs
Publication statusPublished - 2019 Sep 1

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Nomograms
Hepatocellular Carcinoma
Disease-Free Survival
Vitamin K
alpha-Fetoproteins
Lymphocyte Count
Prothrombin
Proportional Hazards Models
Ascites
Calibration
Albumins
Neoplasms
Confidence Intervals
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Kim, Chang Gon ; Lee, Hyun Woong ; Choi, Hye Jin ; Lee, Jung Il ; Lee, Hye Won ; Kim, Seung Up ; Park, Jun Yong ; Kim, Do Young ; Ahn, Sang Hoon ; Han, Kwang Hyub ; Kim, Han Sang ; Kim, Kyung Hwan ; Choi, Seong Jin ; Kim, Yongun ; Lee, Kwan Sik ; Kim, Gyoung Min ; Kim, Man Deuk ; Won, Jong Yoon ; Lee, Do Yun ; Kim, Beom Kyung. / Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation. In: Cancer medicine. 2019 ; Vol. 8, No. 11. pp. 5023-5032.
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title = "Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation",
abstract = "Background: There are large variations in prognosis among hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA). However, current staging or scoring systems hardly discriminate the outcome of HCC patients treated with RFA. Methods: A total of 757 treatment-na{\"i}ve HCC patients undergoing RFA (derivation cohort) were analyzed to establish a nomogram for disease-free survival (DFS) based on Cox proportional hazard regression model. Accuracy of the nomogram was assessed and compared with conventional staging or scoring systems. Furthermore, external validation was performed in an independent cohort including 208 patients (validation cohort). Results: Tumor size, tumor number, alpha-fetoprotein, prothrombin induced by vitamin K absence-II, lymphocyte count, albumin, and presence of ascites were adopted to construct the prognostic nomogram from the derivation cohort. Calibration curves to predict probability of DFS at 3 and 5 years after RFA showed good agreements between the nomogram and actual observations. The concordance index of the present nomogram was 0.759 (95{\%} confidence interval 0.728-0.790), which was superior to those of conventional staging or scoring systems (range 0.505-0.683, all P <.001). These results were also reproduced in the validation cohort. Conclusion: Our simple-to-use nomogram optimized for treatment-na{\"i}ve HCC patients undergoing RFA provided better prognostic performance than conventional staging or scoring systems.",
author = "Kim, {Chang Gon} and Lee, {Hyun Woong} and Choi, {Hye Jin} and Lee, {Jung Il} and Lee, {Hye Won} and Kim, {Seung Up} and Park, {Jun Yong} and Kim, {Do Young} and Ahn, {Sang Hoon} and Han, {Kwang Hyub} and Kim, {Han Sang} and Kim, {Kyung Hwan} and Choi, {Seong Jin} and Yongun Kim and Lee, {Kwan Sik} and Kim, {Gyoung Min} and Kim, {Man Deuk} and Won, {Jong Yoon} and Lee, {Do Yun} and Kim, {Beom Kyung}",
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Kim, CG, Lee, HW, Choi, HJ, Lee, JI, Lee, HW, Kim, SU, Park, JY, Kim, DY, Ahn, SH, Han, KH, Kim, HS, Kim, KH, Choi, SJ, Kim, Y, Lee, KS, Kim, GM, Kim, MD, Won, JY, Lee, DY & Kim, BK 2019, 'Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation', Cancer medicine, vol. 8, no. 11, pp. 5023-5032. https://doi.org/10.1002/cam4.2417

Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation. / Kim, Chang Gon; Lee, Hyun Woong; Choi, Hye Jin; Lee, Jung Il; Lee, Hye Won; Kim, Seung Up; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang Hyub; Kim, Han Sang; Kim, Kyung Hwan; Choi, Seong Jin; Kim, Yongun; Lee, Kwan Sik; Kim, Gyoung Min; Kim, Man Deuk; Won, Jong Yoon; Lee, Do Yun; Kim, Beom Kyung.

In: Cancer medicine, Vol. 8, No. 11, 01.09.2019, p. 5023-5032.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation

AU - Kim, Chang Gon

AU - Lee, Hyun Woong

AU - Choi, Hye Jin

AU - Lee, Jung Il

AU - Lee, Hye Won

AU - Kim, Seung Up

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

AU - Kim, Han Sang

AU - Kim, Kyung Hwan

AU - Choi, Seong Jin

AU - Kim, Yongun

AU - Lee, Kwan Sik

AU - Kim, Gyoung Min

AU - Kim, Man Deuk

AU - Won, Jong Yoon

AU - Lee, Do Yun

AU - Kim, Beom Kyung

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: There are large variations in prognosis among hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA). However, current staging or scoring systems hardly discriminate the outcome of HCC patients treated with RFA. Methods: A total of 757 treatment-naïve HCC patients undergoing RFA (derivation cohort) were analyzed to establish a nomogram for disease-free survival (DFS) based on Cox proportional hazard regression model. Accuracy of the nomogram was assessed and compared with conventional staging or scoring systems. Furthermore, external validation was performed in an independent cohort including 208 patients (validation cohort). Results: Tumor size, tumor number, alpha-fetoprotein, prothrombin induced by vitamin K absence-II, lymphocyte count, albumin, and presence of ascites were adopted to construct the prognostic nomogram from the derivation cohort. Calibration curves to predict probability of DFS at 3 and 5 years after RFA showed good agreements between the nomogram and actual observations. The concordance index of the present nomogram was 0.759 (95% confidence interval 0.728-0.790), which was superior to those of conventional staging or scoring systems (range 0.505-0.683, all P <.001). These results were also reproduced in the validation cohort. Conclusion: Our simple-to-use nomogram optimized for treatment-naïve HCC patients undergoing RFA provided better prognostic performance than conventional staging or scoring systems.

AB - Background: There are large variations in prognosis among hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA). However, current staging or scoring systems hardly discriminate the outcome of HCC patients treated with RFA. Methods: A total of 757 treatment-naïve HCC patients undergoing RFA (derivation cohort) were analyzed to establish a nomogram for disease-free survival (DFS) based on Cox proportional hazard regression model. Accuracy of the nomogram was assessed and compared with conventional staging or scoring systems. Furthermore, external validation was performed in an independent cohort including 208 patients (validation cohort). Results: Tumor size, tumor number, alpha-fetoprotein, prothrombin induced by vitamin K absence-II, lymphocyte count, albumin, and presence of ascites were adopted to construct the prognostic nomogram from the derivation cohort. Calibration curves to predict probability of DFS at 3 and 5 years after RFA showed good agreements between the nomogram and actual observations. The concordance index of the present nomogram was 0.759 (95% confidence interval 0.728-0.790), which was superior to those of conventional staging or scoring systems (range 0.505-0.683, all P <.001). These results were also reproduced in the validation cohort. Conclusion: Our simple-to-use nomogram optimized for treatment-naïve HCC patients undergoing RFA provided better prognostic performance than conventional staging or scoring systems.

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