Nomograms in Hepatectomy Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma.

BACKGROUND: Several conventional staging systems use tumor count as a variable for tumor classification; however, most conventional staging systems for hepatocellular carcinoma (HCC) are not specifically constructed for surgically treated patients. The aim of this study was to create a prognostic nomogram based on patient' clinical and pathological features for predicting individual patient survival after liver resection as a primary therapy for solitary hepatitis B virus (HBV)-related HCC.

METHODS: This study included patients who underwent curative liver resection for preoperative treatment-naïve HBV-related HCC between April 2007 and September 2014. All data were collected prospectively.

RESULTS: A nomogram was generated for HCC recurrence and mortality in 420 hepatectomy patients. HCC recurrence was closely associated with the following factors: increased alkaline phosphatase, low albumin, increased protein induced by vitamin K absence/antagonism-II (PIVKA-II), multiple tumors, tumor hemorrhage, portal vein tumor thrombosis, intrahepatic metastasis, and free resection margin (< 4 cm). Increased alanine transaminase, tumor size ≥ 5 cm, and multiple tumors were predisposing factors for death. Nomograms using those factors had good calibration and discrimination abilities with C-indexes of 0.712 and 0.819, respectively.

CONCLUSIONS: Our results suggest that prognostic nomograms in hepatectomy patients with HBV-related HCC can more precisely estimate postoperative survival of individual HBV-related HCC patients.