title: Analysis of prognostic factors for survival after hepatectomy for hepatocellular carcinoma based on a bayesian network.
abstract: BACKGROUND
  The prognosis of hepatocellular carcinoma (HCC) after hepatectomy involves many factors. Previous studies have evaluated the separate influences of single factors; few have considered the combined influence of various factors. This paper combines the Bayesian network (BN) with importance measures to identify key factors that have significant effects on survival time.
  
  
  METHODS
  A dataset of 299 patients with HCC after hepatectomy was studied to establish a BN using a tree-augmented naïve Bayes algorithm that could mine relationships between factors. The composite importance measure was applied to rank the impact of factors on survival time.
  
  
  RESULTS
  124 patients (>10 months) and 77 patients (≤10 months) were correctly classified. The accuracy of BN model was 67.2%. For patients with long survival time (>10 months), the true-positive rate of the model was 83.22% and the false-positive rate was 48.67%. According to the model, the preoperative alpha fetoprotein (AFP) level and postoperative performance of transcatheter arterial chemoembolization (TACE) were independent factors for survival of HCC patients. The grade of preoperative liver function reflected the tendency for postoperative complications. Intraoperative blood loss, tumor size, portal vein tumor thrombosis (PVTT), time of clamping the porta hepatis, tumor number, operative method, and metastasis were dependent variables in survival time prediction. PVTT was considered the most significant for the prognosis of survival time.
  
  
  CONCLUSIONS
  Using the BN and importance measures, PVTT was identified as the most significant predictor of survival time for patients with HCC after hepatectomy.
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an 710061, Shaanxi, China; Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, Shaanxi, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Cai
authors.affiliation: Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, Shaanxi, China.
authors.forename: Shu-Bin
authors.initials: SB
authors.lastname: Si
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an 710061, Shaanxi, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, Shaanxi, China.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an 710061, Shaanxi, China.
authors.forename: Yong-Yi
authors.initials: YY
authors.lastname: Ma
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an 710061, Shaanxi, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an 710061, Shaanxi, China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Geng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001499:Bayes Theorem; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D055815:Young Adult
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