Development And Validation Of A Novel Prognostic Nomogram For The Early Recurrence Of Liver Cancer After Curative Hepatectomy

Background: Hepatocellular carcinoma(HCC)is one of the most common malignant cancers worldwide.China has the greatest number of cases.Curative resection is an effective treatment,which has resulted in a 5-year survival rate of 11–30% for HCC patients.Due to intrahepatic metastasis and early tumor recurrence,HCC early recurrence(within 2 years of resection)rate accounts for more than70% of total HCC recurrence.To date,there have been few studies examining the prognostic predictors for HCC early recurrence with a 1-year cut-off.This study aimed to establish a novel prognostic nomogram to assess the risk of recurrence in patients following curative resection.Methods: A total of 388 patients undergoing HCC curative resection were recruited from the Guangdong Provincial People’s Hospital(GDPH).The cohort was divided into a training group(n=291)and a validation group(n=97).The risk factors for HCC early recurrence within 1 year of curative hepatectomy were identified.Finally,a multivariate prognostic nomogram was developed and validated.Results: Age,tumor number,tumor capsule,portal vein tumor thrombi,pathological grade,vascular tumor emboli,activated partial thromboplastin time(APTT),and tumor size were identified as independent prognostic risk factors for HCC early recurrence within 1 year of curative hepatectomy.The area under the receiver operating characteristic(ROC)curve(AUC)was 0.806(95% confidence interval 0.755 to 0.857;P<0.001),and no AUC/ROC statistical difference was detected between the training and validation sets.Conclusions: The nomogram effectively predicted postoperative HCC recurrence within 1 year after curative hepatectomy,which may be a useful tool for the postoperative treatment or follow up for HCC patients.