title: Prognostic nomogram for post-surgical treatment with adjuvant TACE in hepatitis B virus-related hepatocellular carcinoma.
abstract: OBJECTIVE
  This study sought to establish an effective and reliable prognostic nomogram to guide the decision for post-surgical adjuvant transarterial chemoembolization (PA-TACE) in patients with hepatitis B virus-related (HBV) hepatocellular carcinoma (HCC).
  
  
  RESULTS
  The 1, 3, 5-year overall survival rates were, respectively, 87.7%, 52.1% and 28.3% in the patients from the derivation set and 91.7%, 57.1% and 34.1% in those from the validation set. Five risk factors (HBV-DNA level, platelet count, vascular invasion, change of Child-Pugh score, and tumor diameter) in the multivariate analysis were significantly associated with prognosis. The statistical nomogram incorporated these five factors achieved good calibration and discriminatory abilities with c-index of 0.75 (95% CI 0.67 to 0.83). The findings were supported by the independent external validation set (c-index, 0.69; 95% CI 0.56 to 0.83). Patients who had a nomogram score of less than 180 was considered to have higher survival benefit from PA-TACE.
  
  
  METHODS
  The nomogram was established based on data obtained from a retrospective study on 235 consecutive patients with HBV HCC who received PA-TACE as an initial therapy from 2006 to 2010 in our center. 84 patients who were collected at another institution between 01/2008 and 12/2010 served as an external validation set. The prognostic nomogram was developed based on the data obtained before the PA-TACE procedure. Predictive accuracy and discriminative ability of the nomogram were assessed by concordance index (C-index), calibration curves, and validation set.
  
  
  CONCLUSIONS
  The novel nomogram may achieve an optimal prognostic prediction for PA-TACE in HBV-related HCC.
authors: Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Hao
authors: H
authors: Hu
authors: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Xi Kun
authors: XK
authors: Han
authors: Sun Yat-sen University Cancer Center, Guangzhou, China.
authors: Xiao Ran
authors: XR
authors: Long
authors: Liver Cancer Institute, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Jia
authors: J
authors: Fan
authors: Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Zhi Ping
authors: ZP
authors: Yan
authors: Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Jian Hua
authors: JH
authors: Wang
authors: Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Rong
authors: R
authors: Liu
mesh_terms: D000368:Aged; D002138:Calibration; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy / Q000821:virology; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000821:virology; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D049451:Nomograms; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: adjuvant transarterial chemoembolization; hepatocellular carcinoma; nomogram