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Prognostic stratification and nomogram for survival prediction in hepatocellular carcinoma patients treated with radiotherapy for lymph node metastasis

Title
Prognostic stratification and nomogram for survival prediction in hepatocellular carcinoma patients treated with radiotherapy for lymph node metastasis
Authors
Wee C.W.Kim K.Chie E.K.Yu S.J.Kim Y.J.Yoon J.H.
Ewha Authors
김규보
SCOPUS Author ID
김규보scopusscopus
Issue Date
2016
Journal Title
British Journal of Radiology
ISSN
0007-1285JCR Link
Citation
vol. 89, no. 1065
Publisher
British Institute of Radiology
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Objective: To establish a prognostic model for overall survival prediction in patients with hepatocellular carcinoma (HCC) treated with external beam radiotherapy (RT) for lymph node (LN) metastasis. Methods: 105 patients with HCC underwent RT for LN metastasis. The median age, biologically effective RT dose and follow-up period were 60 years, 59Gy10 and 5.7 months, respectively. 51 patients had symptoms related to LN metastasis. Results: The median survival (MS) was 5.8 months for all patients. For patients with LN-related symptoms, MS was 3.8 months compared with 10.7 months for those without LN-related symptoms. On multivariate analysis of pre-RT factors, symptoms related to LN metastasis [hazard ratio (HR) 2.93], Child-Pugh Class B-C (HR 2.77), uncontrolled intrahepatic disease (HR 2.74) and non-nodal distant metastasis (HR 1.62) were significantly poor prognostic factors for survival (all p<0.05). Prognostic grouping into three groups by the number of risk factors also had a significant predictive value for survival, with patients having 0, 1, 2 and 3-4 risk factors demonstrating MS of 18.0, 11.7, 5.7 and 3.0 months, respectively (p<0.001). A clinical nomogram based on the four prognostic factors was formulated and demonstrated good accuracy for predicting 6-month survival with a concordance index of 0.77. Conclusion: In a heterogeneous group of patients with HCC treated with RT for LN metastasis, the presence of LN-related symptoms was highly associated with poor survival. The prognostic grouping and nomogram developed by the present study can be effectively used for the prediction of survival. Advances in knowledge: Patients treated with RT for LN metastases harbour various clinical features. Prognostic model and nomogram can help in predicting survival in these patients. © 2016 The Authors.
DOI
10.1259/bjr.20160383
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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