title: Predicting Individual Survival After Hepatectomy for Hepatocellular Carcinoma: a Novel Nomogram from the "HCC East & West Study Group".
abstract: Different staging systems have been devised for patients undergoing resection for hepatocellular carcinoma (HCC) with disparate results. The aim of this study was to create a new nomogram to predict individual survival after hepatectomy for HCC.
  
  
  
  Based on the "Hepatocellular Carcinoma: Eastern & Western Experiences Network," data from 2046 patients who underwent HCC resections at ten centers were reviewed. Patient survival was analyzed with Cox-regression analysis to construct a unique nomogram and contour plots to predict survival.
  
  
  
  The nomograms built on the multivariate analyses, which showed that the independent predictors were tumor size, tumor number, vascular invasion, cirrhosis, preoperative bilirubin value, and esophageal varices, showed good calibration and discriminatory abilities with C-index value of 0.62 (95 % CI, 0.59-0.69) and 0.61 (95 % CI, 0.56-0.64) for overall and disease-free survival, respectively. The 5-year survival contour plots showed that the presence of vascular invasion was associated with decreased survival, regardless of the tumor number or size. Cirrhosis and varices were equally associated with decreased survival, according to the tumor number or size.
  
  
  
  These nomograms accurately predict individual prognosis after HCC resection and support an expansion of the selection criteria for resection. They offer useful guidance to clinicians for individual survival prediction.
authors.affiliation: Department of Hepatobiliary and General Surgery, Humanitas University, Humanitas Research Hospital IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy. guido.torzilli@humanitas.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Torzilli
authors.affiliation: Department of Hepatobiliary and General Surgery, Humanitas University, Humanitas Research Hospital IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Donadon
authors.affiliation: Service de Chirurgie Hepatique et Pancreatique, Hospital Beaujon, University of Paris VII, Clichy Cedex, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.affiliation: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.affiliation: Department HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ferrero
authors.affiliation: Department of Surgery, Hepatobiliary Surgery Unit, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Nuzzo
authors.affiliation: Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vauthey
authors.affiliation: Department of Surgery and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Choti
authors.affiliation: General Surgery and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Gascon, Buenos Aires, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: De Santibanes
authors.affiliation: Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D001808:Blood Vessels / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002648:Child; D018572:Disease-Free Survival; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D049451:Nomograms; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D001663:Bilirubin
keywords: Hepatectomy; Hepatocellular carcinoma; Nomogram; Survival