Prognostic Nomogram for Sorafenib Benefit in Hepatitis B Virus related Hepatocellular Carcinoma after Partial Hepatectomy

Abstract Background The prediction regarding the long-term prognosis of individuals subjected to sorafenib treatment following partial hepatectomy due to hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) is rather difficult.The objective behind this work is to create an effective prognostic nomogram of sorafenib for personalized therapy of HBV-relatedHCC. Methods 234 HBV-related HCC patients subjected or not subjected to sorafenibtreatment following partial hepatectomy at the Eastern Hepatobiliary Surgery Hospital from 2008 to 2013 were compared to investigate the association between index levels and sorafenib benefit. The optimal cut-off point of the overall survival (OS) factor level was determined by x-tile.The selection of indicators is based on clinical findings. The Cox regression model with an interaction term was employed for evaluating the predictive value. Using a multivariate Cox proportional hazards model a Nomogram was subsequently formulated to analyze 113 patients treated with sorafenib. Determination of nomogram’s discriminative ability and predictive accuracy was done using the concordance index (C-index), calibration, and ROC curve. Results Subgroup analysis revealed that Low GPC3,pERK, pAKT, serum AFP levels, without MVI, under 50 years old, male, TNM stage I/II and BCLC stage 0/A wereassociated significantly with a better OS in patients subjected to sorafenib treatment compared to those not treated with sorafenib after surgery. The independent factors for OS were found be GPC3, pERK, pAKT, serum AST and BCLC stage, following multivariate analysis of the sorafenib cohort, which was all included in the nomogram. The survival probability based on the calibration curve shows that the prediction of the nomogram was in good agreement with the actual observation. Survival was predicted to be 0.73(95% CI, 0.67 to 0.78) based on the C-index of the nomogram. The area under the ROC curve (AUC) for the nomogram to predict the survival for 1, 3, and 5-year was 0.726, 0.816, and 0.823, respectively. Conclusion This proposed nomogram has the potential to make quite a precise prediction regarding the prognosis of HBV-related HCC patients,who underwent sorafenib therapy following partial hepatectomy.