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. 2015 Mar 17;5:9202.
doi: 10.1038/srep09202.

A Nomogram for Predicting the Benefit of Adjuvant Cytokine-Induced Killer Cell Immunotherapy in Patients With Hepatocellular Carcinoma

Free PMC article

A Nomogram for Predicting the Benefit of Adjuvant Cytokine-Induced Killer Cell Immunotherapy in Patients With Hepatocellular Carcinoma

Qiu-Zhong Pan et al. Sci Rep. .
Free PMC article


The benefits of adjuvant cytokine-induced killer (CIK) cell immunotherapy for hepatocellular carcinoma (HCC) remain mixed among patients. Here, we constructed a prognostic nomogram to enable individualized predictions of survival benefit of adjuvant CIK cell treatment for HCC patients. Survival analysis showed that the median overall survival (OS) and progression-free survival (PFS) for patients in the hepatectomy/CIK combination group were 41 and 16 months, respectively, compared to 28 and 12 months for patients in the hepatectomy alone group (control). Based on multivariate analysis of the entire cohort, independent factors for OS were tumor size, tumor capsule, pathological grades, total bilirubin, albumin, prothrombin time, alpha-fetoprotein, and tumor number, which were incorporated into the nomogram. The survival prediction model performed well, as assessed by the c-index and calibration curve. Internal validation revealed a c-index of 0.698, which was significantly greater than the c-index value of the TNM (tumor-node-metastasis) staging systems of 0.634. The calibration curves fitted well. In conclusions, our developed nomogram resulted in more accurate individualized predictions of the survival benefit from adjuvant CIK cell treatment after hepatectomy. The model may provide valuable information to aid in the decision making regarding the application of adjuvant CIK cell immunotherapy.


Figure 1
Figure 1. Kaplan–Meier survival curves for patients with hepatocelluar carcinoma (HCC) who received adjuvant CIK cell treatment (n = 511) or surgery alone (n = 520).
(A) Actuarial overall survival (OS) grouped by cytokine-induced killer (CIK) cells. (B) Actuarial progression-free survival (PFS) grouped by CIK cells. The log-rank test showed a significantly higher OS and PFS rate in the CIK group than the control group.
Figure 2
Figure 2. A nomogram for the prediction of 3- and 5-year overall survival for patients who receive adjuvant CIK cell treatment or surgery alone.
The nomogram is used by totaling the points determined at the top of the scale for each factor. This total is then identified on the total points scale to determine the estimated probability of 3- and 5-year overall survival.
Figure 3
Figure 3. A calibration curve for predicting patient survival at (A) 3 and (B) 5 years.
The calibration curve shows how the predictions from the nomogram compared to the actual outcomes for the 1,031 patients.
Figure 4
Figure 4. Kaplan–Meier survival curves for patients from the (A) control and (B) CIK groups, as categorized by TNM staging systems.

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