Using the aMAP Risk Score to Predict Late Recurrence Following Radiofrequency Ablation for Hepatocellular Carcinoma in Chinese Population: A Multicenter Study

Yi Yang; Yanzhao Zhou; Xinyuan Zhang; Yujing Xin; Yi Chen; Qingsheng Fan; Xiao Li; Xi Wei; Qiang Li; Xiang Zhou; Jinxue Zhou

doi:10.2147/JHC.S308587

Using the aMAP Risk Score to Predict Late Recurrence Following Radiofrequency Ablation for Hepatocellular Carcinoma in Chinese Population: A Multicenter Study

J Hepatocell Carcinoma. 2021 Jul 28:8:837-850. doi: 10.2147/JHC.S308587. eCollection 2021.

Authors

Yi Yang^#¹, Yanzhao Zhou^#^{2

3}, Xinyuan Zhang^#¹, Yujing Xin¹, Yi Chen^{1

4}, Qingsheng Fan⁵, Xiao Li¹, Xi Wei⁶, Qiang Li³, Xiang Zhou¹, Jinxue Zhou²

Affiliations

¹ Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China.
² Department of Hepatobiliary and Pancreatic Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, Henan Province, People's Republic of China.
³ Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People's Republic of China.
⁴ Department of Interventional Radiology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, People's Republic of China.
⁵ Department of Oncology, Capital Medical University Affiliated Beijing Hospital of Traditional Chinese Medicine, Beijing, 100010, People's Republic of China.
⁶ Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China.

^# Contributed equally.

Abstract

Objective: This study was conducted to explore the application of age-male-ALBI-platelets (aMAP) score for predicting late recurrence of hepatocellular carcinoma (HCC) following radiofrequency ablation (RFA) and develop an aMAP score based-nomogram to predict prognosis in Chinese population.

Materials and methods: HCC patients who developed late recurrence following RFA at National Cancer Center (NCC) of China, First Hospital of Shanxi Medical University and Beijing Hospital of Traditional Chinese Medicine from January 2011 to December 2016 were included as a training cohort, and patients who were treated at Affiliated Cancer Hospital of Zhengzhou University between January 2012 and December 2016 were included as an external validation cohort. The optimal cut-off value for aMAP score was determined using X-tile software to discriminate the performance of recurrence-free survival (RFS).

Results: A total of 339 eligible patients were included in this study. Patients were grouped into low-risk (aMAP score ≤64.2), medium-risk (64.3 ≤aMAP score ≤68.6) and high-risk (aMAP score ≥68.7) groups by X-tile plots. The prognostic factors that affected RFS were the number of lesions and aMAP score. A nomogram was constructed to predict the RFS with a C-index of 0.793 (95% CI: 0.744-0.842). The time-dependent receiver operating characteristic curves (t-AUCs) of the nomogram to predict 3, 4 and 5-year RFS were 0.808, 0.820 and 0.764, respectively. The model was then tested with data from an external validation cohort. The calibration curve confirmed the optimal agreement between the predicted and observed values.

Conclusion: The aMAP score provided a well-discriminated risk stratification and is an independent prognostic factor for the late recurrence of HCC following RFA. The aMAP score-based nomogram could help to strengthen prognosis-based decision making and formulate adjuvant therapeutic and preventive strategies.

Keywords: age-male-ALBI-platelets score; hepatocellular carcinoma; radiofrequency ablation; recurrence-free survival.

Grants and funding

National Natural Science Foundation of China (30970839&31170957), Research Project of Shanxi Province Health Commission (2017045), Youth Foundation of Pecking Union Medical College (2017320014), Natural Science Foundation of Henan Province (162300410270), Science and Technology Development Foundation of Henan Province (212102310115 &212102310135) Henan Provincial Medical Science and Technology Project (SBGJ202002025 &SBGJ202003009), Henan Medical Science and Technology Innovation Talent Project (YXKC2020045).