Abstract
BackgroundHepatocellular carcinoma (HCC) was rarely discussed in adolescent and young adult (AYA) patients. This study aimed to discuss the character of AYA HCC patients and establish an effective prognostic nomogram for patients after hepatectomy.ResultsFor all of the patients, the median OS was 57 months with 5-year OS rate 60.4%, and DFS was 48 months with 5-year DFS rate 51.4%. The tumor size, vascular invasion status and the pathological differentiation were the independent predictors for both OS and DFS. Except for that, gender, Neutrophil-lymphocyte ratio, HbeAg, and α-Fetoprotein were the predictors for OS. The c-index for OS prognostic nomogram was 0.75 (95% CI, 0.71 to 0.79), and c-index was 0.70 (95% CI, 0.66 to 0.74) for DFS prognostic nomogram, which was better than American Joint Commission on Cancer 2002 and 2010, Okuda staging system, the Japanese Integrated Staging system, and Tokyo staging system.Materials And MethodsThis study was based on 423 AYA HCC patients (younger than 40 years old) undergoing hepatectomy in West China Hospital between 2008 to 2014. Based on the multivariate risk factors, the nomogram was constructed for predict the possibility for overall survival (OS) and disease-free survival (DFS) rate. Harrel’s concordance index (c-index) was used to compare the predictive accuracy and discriminative ability between the nomogram and eight contemporary staging systems.ConclusionsOur prognostic nomogram could accurately and preciously provide individual prediction for AYA HCC patients in OS and DFS after hepatectomy.
Highlights
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, which remains increasing in recent years [1]
Except for that, gender, Neutrophil-lymphocyte ratio, HbeAg, and α-Fetoprotein were the predictors for overall survival (OS)
The c-index for OS prognostic nomogram was 0.75, and c-index was 0.70 for disease-free survival (DFS) prognostic nomogram, which was better than American Joint Commission on Cancer 2002 and 2010, Okuda staging system, the Japanese Integrated Staging system, and Tokyo staging system
Summary
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, which remains increasing in recent years [1]. Occupying less in the whole population, AYA HCC patients were believed with the characters of higher malignant degree, later diagnosis and poorer outcome. It has barely studied previously, especially for the patients younger than 40 years old, which sparkles our inspiration to undertake this study. We aim to evaluate the characteristics of AYA HCC patients and try to create a new staging system of nomogram to predict the outcome of the special group. This study aimed to discuss the character of AYA HCC patients and establish an effective prognostic nomogram for patients after hepatectomy
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