Malignancies and Complications (Videos Available)

Tuesday July 03, 2018 from 09:45 to 11:15

Room: N-101

415.1 Validated nomogram for prediction of recurrence in HCC within Milan criteria (Video Available)

Ka-Wing Ma, Hong Kong

The University of Hong Kong

Abstract

Validated Nomogram for Prediction of Recurrence in HCC within Milan Criteria

Ka-Wing MA1, Kenneth Siu Ho CHOK1, Brian Wong Hoi SHE1, Tan To CHEUNG1, Albert Chi Yan CHAN1, Jeff Wing Chiu DAI1, Chung Mau LO1.

1Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong

Objective: We sought to develop a nomogram for the prediction of tumor recurrence after resection of within Milan hepatocellular carcinoma (HCC)
Methods:Consecutive HCC patients admitted for hepatectomy from 1994 to 2014 were recruited. Patients were excluded if they had recurrent HCC or tumor beyond Milan criteria. Patients were randomized and assigned to derivation and validation set in to 1:1 ratio. Independent factors for disease free survival were identified using cox-regression model. A nomogram was derived and validated with the receiver-operating characteristic (ROC) and calibration curve.
Results: There were 617 eligible patients included for analysis, 481 were male and the median age was 59 year-old. Majority of the patients were Hepatitis B carrier (87.8%). The median follow-up duration was 68.7 months. The 5-year overall survival for the whole population was 73.3% and HCC recurrence was detected in 55% of the patients.
In the derivation set, a nomogram was constructed based on the seven independent factors for disease free survival, namely age, alpha fetal protein (AFP), preoperative prothrombin time, magnitude of hepatectomy, postoperative complication, number of tumor nodule and presence of microvascular invasion. A good discrimination ability was observed in both derivation set and validation set (c-stat 0.672 and 0.665 respectively). Calibration plot yielded good agreement between predicted and observed outcomes using the derived nomogram
Conclusion: A validated nomogram predicts the efficacy of liver resection which help to tailor-make postoperative surveillance and plan for salvage or adjuvant treatment.



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