无法实施根治性手术治疗的晚期HCC患者肝动脉灌注化疗后0.5、1、2年预后预测列线图构建及评价OACSTPCD

Objective To construct the 0.5-,1-,and 2-year prognosis prediction nomogram of advanced hepatocel-lular carcinoma(HCC)patients who can not be treated with radical surgery after hepatic arterial infusion chemotherapy(HAIC)and to conduct the verification and evaluation.Methods Totally124 HCC patients who received HAIC and could not be treated with radical surgery were randomly divided into the training group and validation group according to 6:4.Seventy-four cases in the training group were used to construct the nomogram and to conduct internal validation,and 50 cases in the validation group were used for external verification.Univariate COX analysis was used for survival analysis.The factors included age,sex,Eastern Cooperative Oncology Group(ECOG)score,cirrhosis visible on imaging,tumor size,tumor number,presence of portal cancer thrombin,presence of extrahepatic metastasis,Child-Pugh grade,Alpha fe-toprotein(AFP),aspartate transaminase(AST),alanine aminotransferase(ALT),albumin(Alb),total bilirubin(TBIL),C-reactive protein(CRP),hepatitis B virus(HBV),etc.The prognostic factors of HCC patients receiving HAIC who could not be treated with radical surgery were preliminarily screened.Multivariate COX analysis was then performed to obtain independent prognostic factors for HCC patients who received HAIC and could not be treated with radical sur-gery.Based on the estimated values of COX model parameters in the cohort,the 0.5-,1-,and 2-year prognostic nomo-grams of these patients were constructed.The differentiation and calibration were used to evaluate the prediction effect of the nomogram model.The differentiation of the prediction nomogram was evaluated by analyzing the area under the curve(AUC)of the receiver operating characteristic(ROC)curve.Calibration curves were used to evaluate the degree of cali-bration of the nomogram model.Results Four factors,including tumor size,AFP,cancer embolus,and CRP were inde-pendent prognostic factors for HCC patients who received HAIC and could not be treated with radical surgery.In addition,we successfully constructed a 0.5-,1-,and 2-year prognostic nomogram.ROC analysis results showed that the construct-ed nomogram model predicted that the AUC values of 0.5,1,and 2-year overall survival(OS)rates of HCC patients in the training group who received HAIC and could not be treated with radical surgery were all greater than 0.70,indicating that the constructed nomogram had good differentiation.The calibration curve showed that there was a good consistency be-tween the predicted probability of the constructed nomogram and the actual results.Conclusion A 0.5-,1-,and 2-year prognosis prediction nomogram of HCC patients who received HAIC and could not be treated with radical surgery was suc-cessfully constructed,which was composed of four independent prognostic factors,including tumor size,AFP,cancer em-bolus,and CRP,and its evaluation effect was good.