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Predicting Individual Survival After Hepatectomy for Hepatocellular Carcinoma: a Novel Nomogram from the “HCC East & West Study Group”

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Introductions

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

The authors thank Dr. Claudio Iannacone and his team for the support with the statistical analyses.

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Authors and Affiliations

  1. Department of Hepatobiliary and General Surgery, Humanitas University, Humanitas Research Hospital IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Guido Torzilli & Matteo Donadon

  2. Service de Chirurgie Hepatique et Pancreatique, Hospital Beaujon, University of Paris VII, Clichy Cedex, Paris, France

    Jacques Belghiti

  3. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

  4. Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan

    Tadatoshi Takayama

  5. Department HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Turin, Italy

    Alessandro Ferrero

  6. Department of Surgery, Hepatobiliary Surgery Unit, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy

    Gennaro Nuzzo

  7. Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Jean-Nicolas Vauthey

  8. Department of Surgery and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Michael A. Choti

  9. General Surgery and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Gascon, Buenos Aires, Argentina

    Eduardo De Santibanes

  10. Japanese Red Cross Medical Center, Tokyo, Japan

    Masatoshi Makuuchi

Authors
  1. Guido Torzilli
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  2. Matteo Donadon
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  3. Jacques Belghiti
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  4. Norihiro Kokudo
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  5. Tadatoshi Takayama
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  6. Alessandro Ferrero
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  7. Gennaro Nuzzo
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  8. Jean-Nicolas Vauthey
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  9. Michael A. Choti
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  10. Eduardo De Santibanes
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  11. Masatoshi Makuuchi
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Corresponding author

Correspondence to Guido Torzilli.

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Torzilli, G., Donadon, M., Belghiti, J. et al. Predicting Individual Survival After Hepatectomy for Hepatocellular Carcinoma: a Novel Nomogram from the “HCC East & West Study Group”. J Gastrointest Surg 20, 1154–1162 (2016). https://doi.org/10.1007/s11605-016-3132-0

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  • DOI: https://doi.org/10.1007/s11605-016-3132-0

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