肝癌术后早期复发预测列线图的建立与验证

Establishment and Validation of Nomogram for Predicting Early Postoperative Recurrence of Liver Cancer

摘要: 背景：对于肝细胞癌(HCC)患者而言，肝切除术后早期复发是治疗过程中面临的一项严峻挑战。本研究旨在开发并验证一个新型的模型，用以预测肝切除术后HCC患者的早期复发风险。患者与方法：本项研究回顾性分析了青岛大学附属医院在2013年1月至2021年12月期间，共459例接受根治性肝切除手术的HCC患者。所有参与者按照7:3的比例随机分为训练组(321例)和验证组(178例)。我们结合了多种影响早期复发的风险因素，利用患者的术前临床数据和术后病理特征，构建了一个用于预测肝细胞癌复发风险的列线图模型。结果：我们建立的logistic多因素模型的列线图在预测复发方面表现出较高的准确性，其一致性指标为0.78。经校正的预测曲线与实际预测结果之间展现出良好的一致性。结论：本研究开发的术后列线图模型能够有效预测HCC患者的早期复发率和生存率，这一模型不仅有助于提升治疗效果，同时也可作为临床医生指导肝细胞癌患者治疗决策的有价值工具。

Abstract: Background: Early recurrence after hepatectomy is a formidable challenge in the treatment of hepatocellular carcinoma (HCC) patients. This study aims to develop and validate a novel model for predicting the risk of early recurrence in HCC patients post-hepatectomy. Patients and Methods: This retrospective study analyzed a total of 459 HCC patients who underwent curative liver resection at the Affiliated Hospital of Qingdao University from January 2013 to December 2021. All participants were randomly divided into a training cohort (321 cases) and a validation cohort (178 cases) in a ratio of 7:3. We combined multiple risk factors influencing early recurrence to construct a nomogram model based on preoperative clinical data and postoperative pathological features to predict the recurrence risk of hepatocellular carcinoma. Results: The logistic multifactorial model’s nomogram we established demonstrated high accuracy in predicting recurrence, with a concordance index of 0.78. The calibrated prediction curve showed good consistency with the actual observed outcomes. Conclusion: The postoperative nomogram model developed in this study effectively predicts early recurrence and survival rates in HCC patients. This model not only helps to improve treatment outcomes but also serves as a valuable tool for clinical physicians in guiding treatment decisions for hepatocellular carcinoma patients.