Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study
Abstract Background Early identification of the risk of early cancer-related death (within one year, ECRD) due to recurrence after liver resection for hepatocellular carcinoma (HCC) patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C is important for surgeons to make clinical decisions. Our...
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2025-01-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-03588-6 |
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| author | Zhan-Cheng Qiu Hao-Zheng Cai You-Wei Wu Jun-Long Dai Wei-Li Qi Chu-Wen Chen Yue-Qing Xu Chuan Li Tian-Fu Wen |
| author_facet | Zhan-Cheng Qiu Hao-Zheng Cai You-Wei Wu Jun-Long Dai Wei-Li Qi Chu-Wen Chen Yue-Qing Xu Chuan Li Tian-Fu Wen |
| author_sort | Zhan-Cheng Qiu |
| collection | DOAJ |
| description | Abstract Background Early identification of the risk of early cancer-related death (within one year, ECRD) due to recurrence after liver resection for hepatocellular carcinoma (HCC) patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C is important for surgeons to make clinical decisions. Our study aimed to establish a nomogram to predict the ECRD due to recurrence for HCC patients with BCLC stage B/C. Methods A total of 672 HCC patients with BCLC stages B/C from four medical centers between January 2012 and December 2018 were included in our study. The patients were randomly divided into a training cohort (n = 404) and a validation cohort (n = 268) at a ratio of 6:4. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to establish a nomogram model. Results In our LASSO-logistic regression model, three variables were independently associated with the ECRD due to recurrence: the alpha-fetoprotein-tumor burden score (ATS score, Odd Ratio [OR]: 1.12, p = 0.001), BCLC stage (OR: 4.39, p < 0.001) and the aspartate transaminase (AST) to alanine transaminase (ALT) ratio (AAR, OR: 1.49, p = 0.027) and we established the nomogram model based on these three variables. The nomogram model showed superior predictive ability in the training cohort (Area under the curve [AUC]: 0.754, 95%CI: 0.703–0.804) and the validation cohort (AUC: 0.741, 95%CI: 0.660–0.823). Compared with the ATS score, BCLC stage and AAR, the nomogram both had better predictive ability in both the training cohort (ATS score, AUC: 0.699, 95%CI: 0.646–0.752, p = 0.010; BCLC stage, AUC: AUC: 0.684, 95%CI: 0.637–0.732, p < 0.001; AAR, AUC: 0.593, 95%CI: 0.522–0.663, p < 0.001) and the validation cohort (ATS score, AUC: 0.659, 95%CI: 0.577–0.740, p = 0.002; BCLC stage, AUC: 0.688, 95%CI: 0.622–0.753, p = 0.009; AAR, AUC: 0.540, 95%CI: 0.436–0.645, p < 0.001). Conclusions We established a nomogram that had excellent predictive power for predicting the ECRD due to recurrence in HCC patients with BCLC stage B/C, which might help surgeons to avoid futile liver resection. |
| format | Article |
| id | doaj-art-7d60a7f9f9cb438a8e36640e31264f5c |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-01-01 |
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| series | BMC Gastroenterology |
| spelling | doaj-art-7d60a7f9f9cb438a8e36640e31264f5c2025-01-19T12:25:40ZengBMCBMC Gastroenterology1471-230X2025-01-0125111010.1186/s12876-025-03588-6Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter studyZhan-Cheng Qiu0Hao-Zheng Cai1You-Wei Wu2Jun-Long Dai3Wei-Li Qi4Chu-Wen Chen5Yue-Qing Xu6Chuan Li7Tian-Fu Wen8Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityMedical Data Analytics Center, Department of Medicine and Therapeutics, The Chinese University of Hong KongDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityAbstract Background Early identification of the risk of early cancer-related death (within one year, ECRD) due to recurrence after liver resection for hepatocellular carcinoma (HCC) patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C is important for surgeons to make clinical decisions. Our study aimed to establish a nomogram to predict the ECRD due to recurrence for HCC patients with BCLC stage B/C. Methods A total of 672 HCC patients with BCLC stages B/C from four medical centers between January 2012 and December 2018 were included in our study. The patients were randomly divided into a training cohort (n = 404) and a validation cohort (n = 268) at a ratio of 6:4. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to establish a nomogram model. Results In our LASSO-logistic regression model, three variables were independently associated with the ECRD due to recurrence: the alpha-fetoprotein-tumor burden score (ATS score, Odd Ratio [OR]: 1.12, p = 0.001), BCLC stage (OR: 4.39, p < 0.001) and the aspartate transaminase (AST) to alanine transaminase (ALT) ratio (AAR, OR: 1.49, p = 0.027) and we established the nomogram model based on these three variables. The nomogram model showed superior predictive ability in the training cohort (Area under the curve [AUC]: 0.754, 95%CI: 0.703–0.804) and the validation cohort (AUC: 0.741, 95%CI: 0.660–0.823). Compared with the ATS score, BCLC stage and AAR, the nomogram both had better predictive ability in both the training cohort (ATS score, AUC: 0.699, 95%CI: 0.646–0.752, p = 0.010; BCLC stage, AUC: AUC: 0.684, 95%CI: 0.637–0.732, p < 0.001; AAR, AUC: 0.593, 95%CI: 0.522–0.663, p < 0.001) and the validation cohort (ATS score, AUC: 0.659, 95%CI: 0.577–0.740, p = 0.002; BCLC stage, AUC: 0.688, 95%CI: 0.622–0.753, p = 0.009; AAR, AUC: 0.540, 95%CI: 0.436–0.645, p < 0.001). Conclusions We established a nomogram that had excellent predictive power for predicting the ECRD due to recurrence in HCC patients with BCLC stage B/C, which might help surgeons to avoid futile liver resection.https://doi.org/10.1186/s12876-025-03588-6Early-cancer related deathHepatocellular carcinomaLiver resectionNomogram |
| spellingShingle | Zhan-Cheng Qiu Hao-Zheng Cai You-Wei Wu Jun-Long Dai Wei-Li Qi Chu-Wen Chen Yue-Qing Xu Chuan Li Tian-Fu Wen Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study BMC Gastroenterology Early-cancer related death Hepatocellular carcinoma Liver resection Nomogram |
| title | Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study |
| title_full | Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study |
| title_fullStr | Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study |
| title_full_unstemmed | Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study |
| title_short | Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study |
| title_sort | nomogram for predicting early cancer related death due to recurrence after liver resection in hepatocellular carcinoma patients with barcelona clinic liver cancer bclc stage b c a multicenter study |
| topic | Early-cancer related death Hepatocellular carcinoma Liver resection Nomogram |
| url | https://doi.org/10.1186/s12876-025-03588-6 |
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