Open Access

Identification of predictive factors in hepatocellular carcinoma outcome: A longitudinal study

  • Authors:
    • Huiyuan Tian
    • Shaofeng Cao
    • Mingxing Hu
    • Yuzhu Wang
    • Qiang Fu
    • Yanfeng Pan
    • Tao Qin
  • View Affiliations

  • Published online on: April 28, 2020     https://doi.org/10.3892/ol.2020.11581
  • Pages: 765-773
  • Copyright: © Tian et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Various surgical methods impact the prognosis of patients with hepatocellular carcinoma (HCC) differently. However, clinical guidelines remain inconsistent and the relative importance of predictors of survival outcomes requires further evaluation. The present study aimed to rank the importance of predictive factors that impact the survival outcomes of patients with HCC and to compare the prognosis associated with different surgical methods based on data obtained from the Surveillance, Epidemiology and End Results database. To achieve these aims, the present study used a random forest (RF) model to detect important predictive factors associated with survival outcomes in patients with HCC. Cox regression analysis was used to compare different surgery methods. The variables included in the Cox regression model were selected based on the Gini index calculated by the RF model. Using the RF model, the present study demonstrated that surgery method, tumor size and age were the first, second and third most important factors associated with HCC prognosis, respectively. Overall, patients who underwent local tumor destruction [(hazard ratio (HR)=0.48; 95% confidence interval (CI), 0.45‑0.51; P<0.001)], wedge or segmental resection (HR, 0.31; 95% CI, 0.29‑0.33; P<0.001), lobectomy (HR, 0.29, 95% CI, 0.27‑0.31; P<0.001) or liver transplantation (HR, 0.16; 95% CI, 0.14‑0.17; P<0.001) demonstrated improved overall survival time compared with those treated with surgery, with a gradual decreasing trend observed in HRs. The present study demonstrated that the surgical method used is the most important predictor of the survival outcomes of patients with HCC. Liver transplantation resulted in the best prognosis for patients with HCC, except for those with undifferentiated tumors or distant metastasis.

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July 2020
Volume 20 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

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APA
Tian, H., Cao, S., Hu, M., Wang, Y., Fu, Q., Pan, Y., & Qin, T. (2020). Identification of predictive factors in hepatocellular carcinoma outcome: A longitudinal study. Oncology Letters, 20, 765-773. https://doi.org/10.3892/ol.2020.11581
MLA
Tian, H., Cao, S., Hu, M., Wang, Y., Fu, Q., Pan, Y., Qin, T."Identification of predictive factors in hepatocellular carcinoma outcome: A longitudinal study". Oncology Letters 20.1 (2020): 765-773.
Chicago
Tian, H., Cao, S., Hu, M., Wang, Y., Fu, Q., Pan, Y., Qin, T."Identification of predictive factors in hepatocellular carcinoma outcome: A longitudinal study". Oncology Letters 20, no. 1 (2020): 765-773. https://doi.org/10.3892/ol.2020.11581