Development and Validation of a nomogram for forecasting survival of alcohol related hepatocellular carcinoma patients

Tao Yan; Chenyang Huang; Jin Lei; Qian Guo; Guodong Su; Tong Wu; Xueyuan Jin; Caiyun Peng; Jiamin Cheng; Linzhi Zhang; Zherui Liu; Terence Kin; Fan Ying; Suthat Liangpunsakul; Yinyin Li; Yinying Lu

doi:10.3389/fonc.2022.976445

Development and Validation of a nomogram for forecasting survival of alcohol related hepatocellular carcinoma patients

Front Oncol. 2022 Nov 11:12:976445. doi: 10.3389/fonc.2022.976445. eCollection 2022.

Authors

Tao Yan^{1

2}, Chenyang Huang¹, Jin Lei³, Qian Guo³, Guodong Su¹, Tong Wu¹, Xueyuan Jin⁴, Caiyun Peng¹, Jiamin Cheng¹, Linzhi Zhang¹, Zherui Liu¹, Terence Kin⁵, Fan Ying⁵, Suthat Liangpunsakul⁶, Yinyin Li¹, Yinying Lu^{1

7}

Affiliations

¹ Comprehensive Liver Cancer Center, The Fifth Medical Center of PLA General Hospital, Beijing, China.
² The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
³ The First Affiliated Hospital, Guizhou Medical University, Guiyang, China.
⁴ Medical Quality Control Department, The Fifth Medical Center of PLA General Hospital, Beijing, China.
⁵ Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
⁶ Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.
⁷ Center for Synthetic and Systems Biology (CSSB), Tsinghua University, Beijing, China.

Abstract

Background: With the increasing incidence and prevalence of alcoholic liver disease, alcohol-related hepatocellular carcinoma has become a serious public health problem worthy of attention in China. However, there is currently no prognostic prediction model for alcohol-related hepatocellular carcinoma.

Methods: The retrospective analysis research of alcohol related hepatocellular carcinoma patients was conducted from January 2010 to December 2014. Independent prognostic factors of alcohol related hepatocellular carcinoma were identified by Lasso regression and multivariate COX proportional model analysis, and the nomogram model was constructed. The reliability and accuracy of the model were assessed using the concordance index(C-Index), receiver operating characteristic (ROC) curve and calibration curve. Evaluate the clinical benefit and application value of the model through clinical decision curve analysis (DCA). The prognosis was assessed by the Kaplan-Meier (KM) survival curve.

Results: In sum, 383 patients were included in our study. Patients were stochastically assigned to training cohort (n=271) and validation cohort (n=112) according to 7:3 ratio. The predictors included in the nomogram were splenectomy, platelet count (PLT), creatinine (CRE), Prealbumin (PA), mean erythrocyte hemoglobin concentration (MCHC), red blood cell distribution width (RDW) and TNM. Our nomogram demonstrated excellent discriminatory power (C-index) and good calibration at 1-year, 3-year and 5- year overall survival (OS). Compared to TNM and Child-Pugh model, the nomogram had better discriminative ability and higher accuracy. DCA showed high clinical benefit and application value of the model.

Conclusion: The nomogram model we established can precisely forcasting the prognosis of alcohol related hepatocellular carcinoma patients, which would be helpful for the early warning of alcohol related hepatocellular carcinoma and predict prognosis in patients with alcoholic hepatocellular carcinoma.

Keywords: alcohol; hepatocellular carcinoma; nomogram; overall survival; prognosis.