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Evidence-based decision-making is critical to optimizing the benefits associated with surgery in patients with malignant tumors and reducing ineffective treatment.
Although the mean survival of patients with untreated hepatocellular carcinoma (HCC) is only 6 months, surgery does not only consider the opportunity to "cure" patients, but also whether there are other benefits, such as reduced symptoms and extended survival time.
study aims to develop and validate an individualized tool that predicts the benefits of surgery before surgery and enables patients to achieve survival benefits for at least six months after surgery.
used an international multi-center database to screen patients for liver cancer who under treated liver excision between 2008 and 2017.
were randomly assigned, two-thirds of patients were assigned to the training queue and the remaining one-third were assigned to the validation queue.
independent predictors of death within 6 months of surgery, and used the corresponding online calculator to build a model of nomograms.
the calculator's prediction accuracy using a C index and calibration curve.
independent factors that affect death within 6 months of surgery are age, Child-Pugh grading, frontal hypertension, fetal protein levels, tumor rupture, tumor size, number of tumors, and large blood vessel invasion.
that these factors are included in the training and validation queues show excellent calibration and good performance (C indices 0.802 and 0.798, respectively).
also performed better than the other four currently commonly used stage systems for liver cancer (C index: 0.800 vs. 0.542-0.748).
of the model, the researchers developed an easy-to-use online predictive calculator that can screen patients with a high risk of death within six months of surgery for liver cancer.
online calculator may help guide surgical decisions to avoid unnecessary surgery for liver cancer patients who do not benefit from the operation.
