Prognostic factors and an innovative nomogram model for patients with hepatocellular carcinoma treated with postoperative adjuvant transarterial chemoembolization.
Prognostic factors and an innovative nomogram model for patients with hepatocellular carcinoma treated with postoperative adjuvant transarterial chemoembolization.
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DOI：
10.1080/07853890.2023.2199219
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发表时间：
2023-12
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
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本研究的目的是评估肝细胞癌（HCC）术后辅助经导管动脉化疗栓塞（PA-TACE）的临床疗效并确定最佳受益者。回顾性分析了749例接受手术切除的高复发风险HCC患者（380例接受PA-TACE， 369例仅行切除术）。接受PA-TACE治疗的患者被随机分为开发组和验证组。在发展队列中进行单因素和多因素分析。基于单因素和多因素分析，建立了一种新的pa - tace不敏感预测模型，并在验证集和所有样本中进行了多维度验证。在倾向评分匹配（PSM）后，在早期复发组中，与单独根治性肝切除术相比，PA-TACE没有显著改善RFS。PA-TACE不敏感患者被认为是PA-TACE非获益人群，并且在发展队列中与AFP、淋巴结数、肿瘤包膜、Ki-67指数、MVI和并发症等6个临床病理因素相关。这些因素被纳入到一个nomogram模型中，该模型可靠地预测了PA-TACE的不敏感性，开发队列和验证队列的一致性指数分别为0.874和0.897。在整体样本中，PA-TACE对高评分组患者的RFS和OS无显著改善，而低评分组患者的RFS和OS有统计学意义。复发模式的多样性也被发现是导致PA-TACE不敏感的一个因素。分析PA-TACE患者PA-TACE不敏感的独立影响因素，构建预测模型，并通过多维度方法验证其临床应用性能。根据该模型，评分较高的患者应避免使用PA-TACE治疗，评分较低的患者应综合考虑谨慎推荐使用。与其他相关模型相比，该模型具有明显的通用性和有效性优势。可有效筛选PA-TACE的最佳受益人群，为肝癌根治术后患者选择精准治疗方案提供可靠参考。我们构建了一种新的具有潜在临床价值的pa - tace不敏感预测模型。良好的预测性能和可用性将使该模型能够有效地筛选PA-TACE受益人。
The purpose of this study was to estimate the clinical efficacy and identify the best beneficiaries of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in hepatocellular carcinoma (HCC). A total of 749 HCC patients who underwent surgical resection (380 underwent PA-TACE, 369 had resection only) with a high risk of recurrence were reviewed retrospectively. Patients receiving PA-TACE were randomly split into development and validation cohorts. Univariate and multivariate analyses were performed in the development cohort. A novel model for PA-TACE-insensitivity prediction was built based on univariate and multivariate analysis and was multi-dimensionally validated in the validation set and all samples. After propensity score matching (PSM), in the early-recurrence group, no significant improvement in RFS was achieved with PA-TACE compared to radical hepatic resection alone. PA-TACE insensitive patients were considered as the PA-TACE non-benefit population and were associated with six clinicopathological factors: AFP, node number, tumor capsule, Ki-67 index, MVI, and complications in the development cohort. These factors were incorporated into a nomogram model, which reliably predicted PA-TACE insensitivity, with concordance indices of 0.874 and 0.897 for the development and validation cohort, respectively. In the overall sample, PA-TACE did not significantly improve patients’ RFS and OS in the high-score group, while the low-score group had statistical significance. Recurrence pattern diversity was also found to be a factor leading to PA-TACE insensitivity. The independent influencing factors of PA-TACE insensitivity in patients who received PA-TACE were analyzed to construct a predictive model and its clinical application performance was verified with multi-dimensional methods. PA-TACE treatment should be avoided for patients with high scores according to this model, while it should be cautiously recommended for patients with low scores after multiple considerations. Compared with other related models, this model has obvious advantages in versatility and effectiveness. It can effectively screen the best benefit population of PA-TACE and provide a reliable reference for the selection of precise treatment plans for patients after radical resection of hepatocellular carcinoma. We constructed a new PA-TACE-insensitivity prediction model with potential clinical value. The good predictive performance and availability would allow this model to effectively screen PA-TACE beneficiaries.
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影响因子：
--
作者：
Hu H;Han XK;Long XR;Fan J;Yan ZP;Wang JH;Liu R
通讯作者：
Liu R
影响因子：
1.6
作者：
Sun X;Kaufman PD
通讯作者：
Kaufman PD
乙肝相关肝细胞癌切除后辅助经动脉化疗栓塞：一项随机对照研究
影响因子：
11.5
作者：
Wang, Zheng;Ren, Zhenggang;Zhou, Jian
通讯作者：
Zhou, Jian
影响因子：
5.9
作者：
Lee, Hee Young;Rhim, Hyunchul;Lim, Hyo Keun
通讯作者：
Lim, Hyo Keun
接受辅助经导管动脉化疗栓塞术的肝细胞癌患者的预后预测因素
DOI：
10.1097/meg.0000000000001346
发表时间：
2019-07-01
影响因子：
2.1
作者：
Gu, Jingxian;Zhang, Xing;Liu, Chang
通讯作者：
Liu, Chang