Novel Nomograms Based on Gamma-Glutamyl Transpeptidase-to-Lymphocyte Ratio Predict Prognosis of Hepatocellular Carcinoma Patients After Hepatectomy.

Content Provider	Europe PMC
Author	Ma, Cheng Cao, Yin Zhang, Guang Qiu, Jiannan Zhou, Yan Wang, Peng Wang, Shuo Yan, Dongliang Ma, Ding Jiang, Chunping Wang, Zhongxia
Copyright Year	2023
Abstract	BackgroundThe prediction of prognosis of hepatocellular carcinoma (HCC) is of great significance in improving disease outcome and optimizing clinical management, while reliable prognostic indicators are lacking. This study was conducted to develop readily-to-use nomograms for prognosis prediction of HCC after hepatectomy.Materials and MethodsData of eligible patients were collected and analyzed retrospectively. Independent prognostic factors were identified by Cox regression, and nomograms for the prediction of disease-free survival (DFS) and overall survival (OS) were developed. The performance of the nomograms was evaluated by receiver operating characteristics (ROC) curves, C-indexes and calibration curves and was verified by the validation cohort. The predictive value of the nomograms was also compared with the 8th edition of American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) and the Barcelona Clinic Liver Cancer (BCLC) staging systems.ResultsIn total, 599 patients were enrolled in the analysis: 420 in the training cohort and 179 in the validation cohort. The optimal cut-off value of Gamma-Glutamyl Transpeptidase-to-Lymphocyte Ratio (GLR) was 19.5. GLR contributed significantly to the nomograms with good predictive power. In ROC analyses, the areas under curve (AUCs) of the nomograms for 1-, 3- and 5-year DFS and OS prediction were 0.758, 0.756, 0.734 and 0.810, 0.799, 0.758, respectively. The C-indexes of the DFS nomogram were 0.697 (95% CI 0.665–0.729) in the training cohort and 0.710 (95% CI 0.664–0.756) in the validation cohort. For OS prediction, the C-indexes were 0.741 (95% CI 0.704–0.778) and 0.758 (95% CI 0.705–0.811) in the training and validation cohorts, respectively. The calibration curves demonstrated satisfactory agreement between nomogram predictions and actual observations. The nomograms demonstrated superior predictive performance to the TNM and the BCLC staging systems.ConclusionOur novel nomograms showed adequate performance in the prediction of HCC prognosis after hepatectomy, which may facilitate the risk stratification and individualized management of HCC patients.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9925392&blobtype=pdf
Page Count	14
Journal	Journal of Hepatocellular Carcinoma [J Hepatocell Carcinoma]
Volume Number	10
PubMed Central reference number	PMC9925392
PubMed reference number	36798739
e-ISSN	22535969
DOI	10.2147/jhc.s391755
Language	English
Publisher	Dove
Publisher Date	2023-02-09
Access Restriction	Open
Rights License	This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). © 2023 Ma et al.
Subject Keyword	hepatocellular carcinoma nomogram gamma-glutamyl transferase lymphocyte hepatectomy
Content Type	Text
Resource Type	Article
Subject	Hepatology Oncology