Author:
Liu Yao,Fu Sirui,Yu Xiangrong,Zhang Jinxiong,Zhu Siyu,Yang Yang,Huang Jianwen,Luo Hanlin,Tang Kai,Zheng Youbing,Zhao Yujie,Chen Xiaoqiong,Zhan Meixiao,He Xiaofeng,Li Qiyang,Duan Chongyang,Chen Yuan,Lu Ligong
Abstract
Abstract
Aim
This study aimed to explore whether the addition of sarcopenia and visceral adiposity could improve the accuracy of model predicting progression-free survival (PFS) in hepatocellular carcinoma (HCC).
Methods
In total, 394 patients with HCC from five hospitals were divided into the training and external validation datasets. Patients were initially treated by liver resection or transarterial chemoembolization. We evaluated adipose and skeletal muscle using preoperative computed tomography imaging and then constructed three predictive models, including metabolic (ModelMA), clinical–imaging (ModelCI), and combined (ModelMA−CI) models. Their discrimination, calibration, and decision curves were compared, to identify the best model. Nomogram and subgroup analysis was performed for the best model.
Results
ModelMA−CI containing sarcopenia and visceral adiposity had good discrimination and calibrations (integrate area under the curve for PFS was 0.708 in the training dataset and 0.706 in the validation dataset). ModelMA−CI had better accuracy than ModelCI and ModelMA. The performance of ModelMA−CI was not affected by treatments or disease stages. The high-risk subgroup (scored > 198) had a significantly shorter PFS (p < 0.001) and poorer OS (p < 0.001).
Conclusions
The addition of sarcopenia and visceral adiposity improved accuracy in predicting PFS in HCC, which may provide additional insights in prognosis for HCC in subsequent studies.
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology