Objective To explore the influencing factors of cancer-specific survival of patients with large hepatocellular carcinoma, and draw a nomogram to predict the cancer-specific survival rate of large hepatocellular carcinoma patients.Methods The clinicopathological data of patients with large hepatocellular carcinoma during the period from 1975 to 2017 in the Surveillance, Epidemiology, and End Results (SEER) database were searched and randomly divided into training group and validation group at 1∶1. Using the training data, the Cox proportional hazard regression model was used to explore the influencing factors of cancer-specific survival and construct the nomogram; finally, the receiver operating characteristic curve (ROC curve) and the calibration curve were drawn to verify the nomogram internally and externally.Results The results of the multivariate Cox proportional hazard regression model showed that the degree of liver cirrhosis, tumor differentiation, tumor diameter, T stage, M stage, surgery, and chemotherapy were independent influencing factors that affect the specific survival of patients with large hepatocellular carcinoma (P<0.05), and then these factors were enrolled into the nomogram of the prediction model. The areas under the 1, 3, and 5-year curves of the training group were 0.800, 0.827, and 0.814, respectively; the areas under the 1, 3, and 5-year curves of the validation group were 0.800, 0.824, and 0.801, respectively. The C index of the training group was 0.779, and the verification group was 0.777. The calibration curve of the training group and the verification group was close to the ideal curve of the actual situation.Conclusion The nomogram of the prediction model drawn in this study can be used to predict the specific survival of patients with large hepatocellular carcinoma in the clinic.
WANG Wei, JIN Zongrui, WU Guolin, WANG Jue, YI Qilin, WANG Jilong, XU Banghao, ZHU Hai, PENG Tao, GUO Ya, WEN Zhang. A nomogram to predict prognosis of patients with large hepatocellular carcinoma: a study based on SEER database. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(8): 1016-1024. doi: 10.7507/1007-9424.202012042