A preoperative nomogram for predicting long-term survival after resection of large hepatocellular carcinoma (>10 cm)

• Autores: Ruiz-Figueroa, E, Pineau, P, Flores, C, Fernández, R, Cano, L, Cerapio, JP, Casavilca-Zambrano, S, Berrospi, F, Chávez, I, Roche, B, Bertani, S
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/283
• Enlace del recurso: https://hdl.handle.net/20.500.14703/283
• Nivel de acceso: acceso abierto
• Materia: preoperative nomogram; large hepatocellular carcinoma; https://purl.org/pe-repo/ocde/ford#3.02.21

Background: It has previously been demonstrated that a fraction of patients with hepatocellular carcinoma (HCC) > 10 cm can benefit from liver resection. However, there is still a lack of effective decision-making tools to inform intervention in these patients. Methods: We analysed a comprehensive set of clinical data from 234 patients who underwent liver resection for HCC >10 cm at the National Cancer Institute of Peru between 1990 and 2015, monitored their survival, and constructed a nomogram to predict the surgical outcome based on preoperative variables. Results: We identified cirrhosis, multifocality, macroscopic vascular invasion, and spontaneous tumour rupture as independent predictors of survival and integrated them into a nomogram model. The nomogram's ability to forecast survival at 1, 3, and 5 years was subsequently confirmed with high concordance using an internal validation. Through applying this nomogram, we stratified three groups of patients with different survival probabilities. Conclusion: We constructed a preoperative nomogram to predict long-term survival in patients with HCC >10 cm. This nomogram is useful in determining whether a patient with large HCC might truly benefit from liver resection, which is paramount in low- and middle-income countries where HCC is often diagnosed at advanced stages. © 2021 The Author(s)