Prognostic Factors of Disease-Free Survival in Postoperative Patients with Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) is a primary malignancy of the hepatocyte with high risk of invasion, metastasis and poor prognosis, which leads to a high mortality rate in recent years. This study aims to investigate the independent prognosis factors of DFS(disease free survival) in primary hepatocellular carcinoma patients after radical hepatectomy and construct a nomogram prediction model. Methods This study retrospectively analyzed 358 patients admitted to the 1st Affiliated Hospital of Anhui Medical College from December 2009 to December 2014. Categorical variables were analyzed by chi-square test. The survival curve was plotted by kaplan-meier method and tested by log-rank method. Univariate and multivariate cox regression analyses were performed to determine the prognostic factors. A nomogram was constructed to predict the 3-year and 5-year DFS of HCC patients based on these factors. The performance of the nomogram was assessed with the C-indexes and calibration plot diagrams. Results Among the 344 patients with HCC, 298 cases (86.63%) are young patients (<70years), and 46 cases (13.37%) were elderly patients (≥70 years). The univariate and multivariate analyses showed that age, TNM stage, history of hepatitis B were the independent factors for DFS. The Kaplan-Meier curves indicated that elderly patients, TNM I-II stage and no history of hepatitis B had longer DFS. The C-index of the nomogram was 0.604(95%CI:0.561-0.647), and the Calibration curve showed that the actual DFS curve of the nomogram fits the predicted DFS curve. Conclusions Our findings suggested that age, TNM stage, history of hepatitis B were independent factors for predicting DFS of HCC patients. Patients older than 70 years had a better prognosis than young patients. Patients with early TNM stage and no history of hepatitis B had longer DFS. We constructed and validated a new nomogram for predicting DFS in HCC patients.