Development and Validation of a Prognostic Model for Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma Based on Preoperative Serum Prealbumin

Figures & data

Table 1 Baseline Differences Between Training and Validation Cohort

Clinical Characteristics	Training Cohort	Validation Cohort	P-value
Gender			0.931
Male	380 (82.4%)	254 (82.7%)
Female	81 (17.6%)	53 (17.3%)
Age years			0.066
>60	246 (53.4%)	143 (46.6%)
≤60	215 (46.6%)	164 (53.4%)
CTP			0.362
A	403 (87.4%)	275 (89.6%)
B	58 (12.6%)	32 (10.4%)
Size cm			0.737
<5	167 (36.2%)	103 (33.6%)
5~10	181 (39.3%)	124 (40.3%)
>10	113 (24.5%)	80 (26.1%)
Number			0.648
<3	231 (50.1%)	159 (51.8%)
≥3	230 (49.9%)	148 (48.2%)
Location			0.441
Single lobe	320 (69.4%)	205 (66.8%)
Double lobe	141 (30.6%)	102 (33.2%)
Cirrhosis			0.114
Yes	206 (44.7%)	155 (50.5%)
No	255 (55.3%)	152 (49.5)
Ascites			0.811
yes	72 (15.6%)	46 (15.0%)
No	389 (84.4%)	261 (85.0%)
HBV			0.655
Yes	287 (62.3%)	196 (63.8%)
No	174 (37.7%)	111 (36.2%)
AST U/L			0.383
≤40	219 (47.5%)	136 (44.3%)
>40	242 (52.3%)	171 (55.7%)
ALT U/L			0.321
≤40	266 (57.7%)	166 (54.1%)
>40	195 (42.3%)	141 (45.9%)
PALB mg/L			0.844
≤170	302 (65.5%)	199 (64.8%)
>170	159 (34.5%)	108 (35.2%)
Bilirubin μmol/L			0.486
≤21	354 (76.8%)	229 (74.6%)
>21	107 (23.2%)	78 (25.4%)
ALB g/L			0.011
≤35	149 (32.3%)	73 (23.8%)
>35	312 (67.7%)	234 (76.2%)
AFP ng/mL			0.234
≤400	267 (57.9%)	191 (62.2%)
>400	194 (42.1%)	116 (37.8%)
PS			0.694
0	104 (22.6%)	73 (23.8%)
1~2	357 (77.4%)	234 (76.2%)
BCLC			0.548
A	25 (5.4%)	17 (5.5%)
B	279 (60.5%)	197 (64.2%)
C	157 (34.1%)	93 (30.3%)
Invasion			0.639
Yes	64 (13.9%)	39 (12.7%)
No	397 (86.1%)	268 (87.3%)
PT s
≤13	352 (76.4%)	234 (76.2%)	0.966
>13	109 (23.6%)	73 (23.8%)

Abbreviations: CTP, Child-Turcotte-Pugh; HBV, Hepatitis B Virus; AST, Aspartate Aminotransferase; ALT, Alanine Aminotransferase; PALB, Prealbumin; ALB, Albumin; AFP, Alpha-Fetoprotein; PS, Performance Status; BCLC, Barcelona Clinic Liver Cancer; PT, Prothrombin Time.

Table 2 Univariate and Multivariate Cox Regression Analyses of OS in Training Cohort

Characteristics	Univariable Cox Regression			Multivariable Cox Regression
	HR	95% CI	P-value	HR	95% CI	P-value
AFP	0.58	1.41–2.11	<0.001
Age	1.13	0.73–1.07	0.212
ALB	1.4	0.57–0.9	0.004
ALT	0.89	0.92–1.37	0.247
Ascites	0.74	1.05–1.75	0.022
AST	0.55	1.48–2.22	<0.001
BCLC	0.4	2.07–2.94	<0.001	1.77	1.39–2.24	<0.001
Bilirubin	0.9	0.89–1.38	0.342
Cirrhosis	1.22	0.68–1.00	0.049	0.72	0.57–0.90	0.004
CTP	0.74	0.98–1.84	0.066
Gender	1.05	0.73–1.23	0.694
HBV	0.81	1.02–1.51	0.03
Invasion	0.34	2.35–3.63	<0.001	1.57	1.15–2.16	0.005
Location	0.65	1.26–1.9	<0.001
Number	0.65	1.26–1.87	<0.001	1.52	1.23–1.88	<0.001
PALB	1.8	0.44–0.70	<0.001	0.71	0.56–0.91	0.006
PS	0.59	1.36–2.08	<0.001	1.67	1.35–2.08	<0.001
PT	0.7	1.17–1.74	<0.001
Size	0.57	1.53–1.98	<0.001	1.53	1.32–1.77	<0.001

Abbreviations: CTP, Child-Turcotte-Pugh; HBV, Hepatitis B Virus; AST, Aspartate Aminotransferase; ALT, Alanine Aminotransferase; PALB, Prealbumin; ALB, Albumin; AFP, Alpha-Fetoprotein; PS, Performance Status; BCLC, Barcelona Clinic Liver Cancer; PT, Prothrombin Time.

Figure 1 Nomogram for predicting the OS of unresectable hepatocellular carcinoma patients in the training cohort at 1-, 2-, and 3 years.

Figure 2 ROC curve and AUC of the nomogram to predict 1-, 2-, and 3-year OS in training cohort (A) and validation cohort (B).

Figure 3 The calibration plots of the nomogram for 1-, 2-, and 3-year survival probabilities in training and validation cohort. (A) One-year OS of the training cohort. (B) Two-year OS of the training cohort. (C) Three-year OS of the training cohort. (D) One-year 0S of the validation cohort. (E) Two-year OS of the validation cohort. (F) Three-year OS of the validation cohort.

Figure 4 DCA for the nomogram predicting 1-, 2-, and 3-year OS in the training and validation cohorts. (A) One-year OS of the training cohort. (B) Two-year OS of the training cohort. (C) Three-year OS of the training cohort. (D) One-year 0S of the validation cohort. (E) Two-year OS of the validation cohort. (F) Three-year OS of the validation cohort.

Figure 5 Kaplan-Meier curves of unresectable hepatocellular carcinoma patients in the low-risk and high-risk groups in training cohort (A) and validation cohort (B).

Figure 6 AUC and 95% CI of the Nomogram and Conventional Prognostic Staging Systems.