当前位置: X-MOL 学术Int. J. Hyperth. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Nomograms to predict survival outcomes after microwave ablation in elderly patients (>65 years old) with early-stage hepatocellular carcinoma.
International Journal of Hyperthermia ( IF 3.1 ) Pub Date : 2020-07-03 , DOI: 10.1080/02656736.2020.1785556
Zhimei Huang 1 , Yangkui Gu 1 , Tianqi Zhang 1 , Shaoyong Wu 2 , Xiuchen Wang 1 , Chao An 1 , Jinhua Huang 1
Affiliation  

Abstract

Objectives: To develop and validate the nomograms to predict survival outcomes after microwave ablation (MWA) in elderly patients(>65 years old) with early-stage hepatocellular carcinoma (EHCC).

Methods: This retrospective study was approved by the institutional review board. A total of 265 EHCC patients (76 females, 189 males; average age 71.4 years ± 5.4 [standard deviation]) with 345 nodules subsequently underwent MWA from April 2006 to October 2019. Baseline characteristics were collected to identify the risk factors for the determination of survival outcomes after MWA. The nomograms were based on prognostic factors for overall survival (OS) and recurrence-free survival (RFS) from the multivariate Cox proportional hazards model and validated in external cohorts from another two institutions (n = 130). The nomograms were assessed for their predictive accuracy using Harrell’s concordance index (C-index).

Results: After a median follow-up time of 28.6 months, 29.8% (79/265) of the patients died, and 54.3% (144/265) of the patients experienced recurrence in the training set. The OS nomogram was developed based on the hepatitis B virus (HBV) presence, α-fetoprotein (AFP), and albumin, with a C-index of 0.757 (95% confidence interval [CI]: 0.645, 0.789).The scores of the nomogram ranged from 0 to 24. The RFS nomogram was developed based on tumor number, abutting major vessels and platelets, with a C-index of 0.733 (CI: 0.672, 0.774). The likelihood of 3- and 5-year OS and RFS were consistent between clinical observations and nomogram predictions in external cohorts.

Conclusions: The nomogram models can be useful in determining the risk of OS and RFS in elderly patients with EHCC after MWA, which can guide individual patient management.

  • Key points
  • MWA is an effective and feasible treatment for elderly patients with EHCC and can improve survival outcomes.

  • A calibrated and objective nomogram model for the prediction of survival outcomes in elderly patients (>65 years old) may guide patient selection and MWA treatment.

  • Older age was not deemed to be a risk factor for survival outcomes when the elderly patients with EHCC underwent MWA.



中文翻译:

诺法图可预测早期肝细胞癌老年患者(> 65岁)在微波消融后的生存结果。

摘要

目的:开发和验证列线图,以预测老年肝细胞癌(EHCC)(> 65岁)的微波消融(MWA)后的生存结果。

方法:这项回顾性研究得到机构审查委员会的批准。从2006年4月至2019年10月,总共265例EHCC患者(76例女性,189例男性;平均年龄71.4岁±5.4 [标准差])随后有345个结节接受了MWA。收集基线特征以鉴定确定HCC的危险因素。 MWA后的生存结果。诺模图基于多变量Cox比例风险模型的总生存期(OS)和无复发生存期(RFS)的预后因素,并在另外两个机构的外部队列中进行了验证(n  = 130)。使用Harrell一致性指数(C-index)评估了诺模图的预测准确性。

结果:在中位随访28.6个月之后,有29.8%(79/265)的患者死亡,而54.3%(144/265)的患者在训练组中复发。OS诺模图是根据乙型肝炎病毒(HBV)的存在,甲胎蛋白(AFP)和白蛋白绘制的,C指数为0.757(95%置信区间[CI]:0.645,0.789)。诺模图的范围从0到24。RFS诺模图是基于肿瘤数目而开发的,毗邻主要血管和血小板,C指数为0.733(CI:0.672,0.774)。在外部人群中,临床观察和列线图预测之间3年和5年OS和RFS的可能性一致。

结论:列线图模型可用于确定MWA后老年EHCC患者OS和RFS的风险,可指导个体患者的治疗。

  • 关键点
  • MWA是老年EHCC患者的一种有效可行的治疗方法,可以提高生存率。

  • 用于预测老年患者(> 65岁)生存结果的校准客观客观列线图模型可以指导患者选择和MWA治疗。

  • 当老年EHCC患者接受MWA时,年龄不被认为是生存结果的危险因素。

更新日期:2020-07-05
down
wechat
bug