Objective: To develop a prognostic model for overall survival (OS) in hepatocellular carcinoma (HCC) patients receiving radiotherapy (RT) to metastatic abdominal lymph nodes (LNs). Materials and Methods: Two hundred twenty-eight patients treated with RT to metastatic abdominal LNs were retrospectively reviewed. Results: Median OS in all patients was 11.1 months. LN responders had significantly higher median OS than non-responders (14.2 months vs. 7.5 months, p < 0.05). On multivariate analysis, Child-Pugh classification, status of intrahepatic tumor, presence of distant metastasis, number and location of metastatic LNs, serum level of alpha fetoprotein (AFP), and the LN response to RT were significant prognostic factors for OS (p < 0.05 each). Based on the results of multivariate analysis, prognostic group stratification according to the number of pre-treatment risk factors was a significant predictor of OS, and median OS in patients with ≥ 4, 3, 2, 1, and 0 risk factors were 2.9, 5.5, 10.3, 13.6, and 27.8 months, respectively (p < 0.05). A nomogram was formulated by integrating the different prognostic contribution of each factor, and it showed good accuracy for predicting 2-year OS with a concordance index of 0.72. Conclusion: Prognostic group stratification and nomogram could be useful prognostic and therapeutic indicators in selecting treatment strategies.
Bibliographical noteFunding Information:
The present affiliation of Y. Kim is the Department of Radiation Oncology, Kyung Hee University Hospital, Seoul, Korea. This study was supported by National Cancer Center Grant (NCC 1710060 and 1710030).
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