Prognosis of hepatic angiosarcoma and establishment of predictive nomogram_Chinese Journal of Evidence-Based Medicine

Authors：

TIAN Huiyuan ¹ , LI Li ¹ , FU Qiang ² ,  QIN Tao ²

1. Department of Research and Discipline Development, Henan Provincial People’s Hospital (Zhengzhou University People’s Hospital/Henan University People’s Hospital), Zhengzhou 450003, P.R.China;
2. Department of Hepatobiliary and Pancreatic Surgery, Henan Provincial People’s’ Hospital (Zhengzhou University People’s Hospital/Henan University People’s Hospital), Zhengzhou 450003, P.R.China;

Corresponding author：

QIN Tao, Email: goodfreecn@163.com

Keywords：

Hepatocellular carcinoma; Hepatic angiosarcoma; Prognosis; Nomogram; Propensity score; Surveillance, Epidemiology and End Results (SEER) database

DOI：

10.7507/1672-2531.201910127

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objectives To compare the survival outcomes between hepatocellular carcinoma and hepatic angiosarcoma, and to develop and validate a nomogram predicting the outcome of hepatic angiosarcoma.Methods The Surveillance, Epidemiology and End Results (SEER) database was electronically searched to collect the data of hepatic angiosarcoma patients and hepatocellular carcinoma patients from 2004 to 2016. Propensity score matching (PSM) was used to match the two groups by the ratio of 1:3. Cox regression analysis was used to compare the survival outcomes between hepatic angiosarcoma and HCC. In the angiosarcoma group, population was divided into training set and validation set by 6:4. Nomograms were built for the prediction of half- and one- year survival, and validated by concordance index (C-index) and calibration plots.Results A total of 210 histologically confirmed hepatic angiosarcoma patients and 630 hepatocellular carcinoma patients were included. The overall survival of HCC was significantly longer than angiosarcoma (3-year survival: 18.4% vs. 6.7%, median survival: 5 months vs. 1 month, P<0.001), and the nomogram achieved good accuracy with an internal C-index of 0.751 and an external C-index of 0.737.Conclusions The overall survival of HCC is significantly longer than angiosarcoma. The proposed nomograms can assist to predict survival probability in patients with hepatic angiosarcoma. Due to limitation of the data of included patients, more high-quality studies are required to verify above conclusions.

Citation： TIAN Huiyuan, LI Li, FU Qiang, QIN Tao. Prognosis of hepatic angiosarcoma and establishment of predictive nomogram. Chinese Journal of Evidence-Based Medicine, 2020, 20(4): 395-402. doi: 10.7507/1672-2531.201910127 Copy

1.	Li DB, Si XY, Wan T, et al. A pooled analysis of treatment and prognosis of hepatic angiosarcoma in adults. Hepatobiliary Pancreat Dis Int, 2018, 17(3): 198-203.
2.	Tsunematsu S, Muto S, Oi H, et al. Surgically diagnosed primary hepatic angiosarcoma. Intern Med, 2018, 57(5): 687-691.
3.	Chien CY, Hwang CC, Yeh CN, et al. Liver angiosarcoma, a rare liver malignancy, presented with intra-abdominal bleeding due to rupture-a case report. World J Surg Oncol, 2012, 10(1): 23.
4.	Yi LL, Zhang JX, Zhou SG, et al. CT and MRI studies of hepatic angiosarcoma. Clin Radiol, 2019, 74(5): 406.
5.	Chaudhary P, Bhadana U, Singh RA, et al. Primary hepatic angiosarcoma. Eur J Surg Oncol, 2015, 41(9): 1137-1143.
6.	Wilson GC, Lluis N, Nalesnik MA, et al. Hepatic angiosarcoma: a multi-institutional, international experience with 44 cases. Ann Surg Oncol, 2019, 26(2): 576-582.
7.	Coppola A, Bianco G, Ardito F, et al. Primary hepatic angiosarcoma. ANZ J Surg, 2018, 88(1-2): E75-E76.
8.	Tripke V, Heinrich S, Huber T, et al. Surgical therapy of primary hepatic angiosarcoma. BMC Surg, 2019, 19(1): 5.
9.	Kim HR, Rha SY, Cheon SH, et al. Clinical features and treatment outcomes of advanced stage primary hepatic angiosarcoma. Ann Oncol, 2009, 20(4): 780-787.
10.	Lin Z, Yan S, Zhang J, et al. A nomogram for distinction and potential prediction of liver metastasis in breast cancer patients. J Cancer, 2018, 9(12): 2098-2106.
11.	Sonpavde G, Pond GR, Rosenberg JE, et al. Nomogram to assess the survival benefit of new salvage agents for metastatic urothelial carcinoma in the era of immunotherapy. Clin Genitourin Cancer, 2018, 16(4): e961-e967.
12.	Chen G, Yu H, Wang Y, et al. A novel nomogram for the prediction of intrahepatic cholangiocarcinoma in patients with intrahepatic lithiasis complicated by imagiologically diagnosed mass. Cancer Manag Res, 2018, 10: 847-856.
13.	Roberto M, Botticelli A, Strigari L, et al. Prognosis of elderly gastric cancer patients after surgery: a nomogram to predict survival. Med Oncol, 2018, 35(7): 111.
14.	Chen S, Lai Y, He Z, et al. Establishment and validation of a predictive nomogram model for non-small cell lung cancer patients with chronic hepatitis B viral infection. J Transl Med, 2018, 16(1): 116.
15.	Wang X, Yu GY, Chen M, et al. Pattern of distant metastases in primary extrahepatic bile-duct cancer: a SEER-based study. Cancer Med, 2018, 7(10): 5006-5014.
16.	Liu W, Wang K, Han Y, et al. Nomogram predicted disease free survival for colorectal liver metastasis patients with preoperative chemotherapy followed by hepatic resection. Eur J Surg Oncol, 2019, 45(11): 2070-2077.
17.	Brookhart MA, Wyss R, Layton JB, et al. Propensity score methods for confounding control in nonexperimental research. Circ Cardiovasc Qual Outcomes, 2013, 6(5): 604-611.
18.	Cochran WG. Matching in analytical studies. Am J Public Health Nations Health, 1953, 43(6 Pt 1): 684-691.
19.	Stürmer T, Joshi M, Glynn RJ, et al. A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods. J Clin Epidemiol, 2006, 59(5): 437-447.
20.	Inokuchi M, Nakagawa M, Tanioka T, et al. Long- and short-term outcomes of laparoscopic gastrectomy versus open gastrectomy in patients with clinically and pathological locally advanced gastric cancer: a propensity-score matching analysis. Surg Endosc, 2018, 32(2): 735-742.
21.	Hayashida S, Soutome S, Yanamoto S, et al. Evaluation of the treatment strategies for medication-related osteonecrosis of the jaws (MRONJ) and the factors affecting treatment outcome: a multicenter retrospective study with propensity score matching analysis. J Bone Miner Res, 2017, 32(10): 2022-2029.
22.	Wong TCL, Ng KKC, Fung JYY, et al. Long-term survival outcome between living donor and deceased donor liver transplant for hepatocellular carcinoma: intention-to-treat and propensity score matching analyses. Ann Surg Oncol, 2019, 26(5): 1454-1462.
23.	Zhao LY, Zhao YL, Wang JJ, et al. Is preoperative fibrinogen associated with the survival prognosis of gastric cancer patients? A multi-centered, propensity score-matched retrospective study. World J Surg, 2020, 44(1): 213-222.
24.	Zhang W, Sun B. Impact of age on the survival of patients with liver cancer: an analysis of 27255 patients in the SEER database. Oncotarget, 2015, 6(2): 633-641.
25.	Hashimoto M, Tashiro H, Kobayashi T, et al. Clinical characteristics and prognosis of non-B, non-C hepatocellular carcinoma: The impact of patient sex on disease-free survival - A retrospective cohort study. Int J Surg, 2017, 39: 206-213.
26.	Wang S, Sun H, Xie Z, et al. Improved survival of patients with hepatocellular carcinoma and disparities by age, race, and socioeconomic status by decade, 1983-2012. Oncotarget, 2016, 7(37): 59820-59833.
27.	Jones PD, Diaz C, Wang D, et al. The impact of race on survival after hepatocellular carcinoma in a diverse American population. Dig Dis Sci, 2018, 63(2): 515-528.

1. Li DB, Si XY, Wan T, et al. A pooled analysis of treatment and prognosis of hepatic angiosarcoma in adults. Hepatobiliary Pancreat Dis Int, 2018, 17(3): 198-203.
2. Tsunematsu S, Muto S, Oi H, et al. Surgically diagnosed primary hepatic angiosarcoma. Intern Med, 2018, 57(5): 687-691.
3. Chien CY, Hwang CC, Yeh CN, et al. Liver angiosarcoma, a rare liver malignancy, presented with intra-abdominal bleeding due to rupture-a case report. World J Surg Oncol, 2012, 10(1): 23.
4. Yi LL, Zhang JX, Zhou SG, et al. CT and MRI studies of hepatic angiosarcoma. Clin Radiol, 2019, 74(5): 406.
5. Chaudhary P, Bhadana U, Singh RA, et al. Primary hepatic angiosarcoma. Eur J Surg Oncol, 2015, 41(9): 1137-1143.
6. Wilson GC, Lluis N, Nalesnik MA, et al. Hepatic angiosarcoma: a multi-institutional, international experience with 44 cases. Ann Surg Oncol, 2019, 26(2): 576-582.
7. Coppola A, Bianco G, Ardito F, et al. Primary hepatic angiosarcoma. ANZ J Surg, 2018, 88(1-2): E75-E76.
8. Tripke V, Heinrich S, Huber T, et al. Surgical therapy of primary hepatic angiosarcoma. BMC Surg, 2019, 19(1): 5.
9. Kim HR, Rha SY, Cheon SH, et al. Clinical features and treatment outcomes of advanced stage primary hepatic angiosarcoma. Ann Oncol, 2009, 20(4): 780-787.
10. Lin Z, Yan S, Zhang J, et al. A nomogram for distinction and potential prediction of liver metastasis in breast cancer patients. J Cancer, 2018, 9(12): 2098-2106.
11. Sonpavde G, Pond GR, Rosenberg JE, et al. Nomogram to assess the survival benefit of new salvage agents for metastatic urothelial carcinoma in the era of immunotherapy. Clin Genitourin Cancer, 2018, 16(4): e961-e967.
12. Chen G, Yu H, Wang Y, et al. A novel nomogram for the prediction of intrahepatic cholangiocarcinoma in patients with intrahepatic lithiasis complicated by imagiologically diagnosed mass. Cancer Manag Res, 2018, 10: 847-856.
13. Roberto M, Botticelli A, Strigari L, et al. Prognosis of elderly gastric cancer patients after surgery: a nomogram to predict survival. Med Oncol, 2018, 35(7): 111.
14. Chen S, Lai Y, He Z, et al. Establishment and validation of a predictive nomogram model for non-small cell lung cancer patients with chronic hepatitis B viral infection. J Transl Med, 2018, 16(1): 116.
15. Wang X, Yu GY, Chen M, et al. Pattern of distant metastases in primary extrahepatic bile-duct cancer: a SEER-based study. Cancer Med, 2018, 7(10): 5006-5014.
16. Liu W, Wang K, Han Y, et al. Nomogram predicted disease free survival for colorectal liver metastasis patients with preoperative chemotherapy followed by hepatic resection. Eur J Surg Oncol, 2019, 45(11): 2070-2077.
17. Brookhart MA, Wyss R, Layton JB, et al. Propensity score methods for confounding control in nonexperimental research. Circ Cardiovasc Qual Outcomes, 2013, 6(5): 604-611.
18. Cochran WG. Matching in analytical studies. Am J Public Health Nations Health, 1953, 43(6 Pt 1): 684-691.
19. Stürmer T, Joshi M, Glynn RJ, et al. A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods. J Clin Epidemiol, 2006, 59(5): 437-447.
20. Inokuchi M, Nakagawa M, Tanioka T, et al. Long- and short-term outcomes of laparoscopic gastrectomy versus open gastrectomy in patients with clinically and pathological locally advanced gastric cancer: a propensity-score matching analysis. Surg Endosc, 2018, 32(2): 735-742.
21. Hayashida S, Soutome S, Yanamoto S, et al. Evaluation of the treatment strategies for medication-related osteonecrosis of the jaws (MRONJ) and the factors affecting treatment outcome: a multicenter retrospective study with propensity score matching analysis. J Bone Miner Res, 2017, 32(10): 2022-2029.
22. Wong TCL, Ng KKC, Fung JYY, et al. Long-term survival outcome between living donor and deceased donor liver transplant for hepatocellular carcinoma: intention-to-treat and propensity score matching analyses. Ann Surg Oncol, 2019, 26(5): 1454-1462.
23. Zhao LY, Zhao YL, Wang JJ, et al. Is preoperative fibrinogen associated with the survival prognosis of gastric cancer patients? A multi-centered, propensity score-matched retrospective study. World J Surg, 2020, 44(1): 213-222.
24. Zhang W, Sun B. Impact of age on the survival of patients with liver cancer: an analysis of 27255 patients in the SEER database. Oncotarget, 2015, 6(2): 633-641.
25. Hashimoto M, Tashiro H, Kobayashi T, et al. Clinical characteristics and prognosis of non-B, non-C hepatocellular carcinoma: The impact of patient sex on disease-free survival - A retrospective cohort study. Int J Surg, 2017, 39: 206-213.
26. Wang S, Sun H, Xie Z, et al. Improved survival of patients with hepatocellular carcinoma and disparities by age, race, and socioeconomic status by decade, 1983-2012. Oncotarget, 2016, 7(37): 59820-59833.
27. Jones PD, Diaz C, Wang D, et al. The impact of race on survival after hepatocellular carcinoma in a diverse American population. Dig Dis Sci, 2018, 63(2): 515-528.

Chinese Journal of Evidence-Based Medicine

Prognosis of hepatic angiosarcoma and establishment of predictive nomogram

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