Development and Validation of a Predictive Model for Early Refractoriness of Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma.
Development and Validation of a Predictive Model for Early Refractoriness of Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma.
复制标题
DOI：
10.3389/fmolb.2021.633590
复制
发表时间：
2021
影响因子：
5
通讯作者：
Xiao YD
中科院分区：
文献类型：
--
作者：
Wang TC;An TZ;Li JX;Zhang ZS;Xiao YD
目的：建立和验证肝细胞癌患者肝动脉化疗栓塞术(TACE)早期无效的预测模型。方法：在这项多中心的回顾性研究中，共有204名首次接受TACE的连续患者纳入研究。早期TACE难治的定义是在最初连续两次TACE手术后出现TACE难治的患者。在所有患者中，147名患者(约70%)被分配到训练组，其余57名患者(约30%)被分配到验证组。应用前向逐步Logistic回归和诺模图建立预测模型。根据Logistic回归筛选的因素，进行一对一倾向评分匹配(PSM)，比较有无早期TACE难治性患者的无进展生存率(PFS)。PFS曲线估计采用Kaplan-Meier法，比较采用对数等级检验。结果：Logistic回归分析显示，胆叶肿瘤的分布(p=0.002)、3个以上的肿瘤(p=0.005)和超过7个标准的肿瘤(p=0.001)与早期介入治疗的难治性显著相关。根据受试者工作特征曲线下面积确定的辨别能力，在训练队列中为0.788，在验证队列中为0.706。经皮冠状动脉腔内成形术后，结果显示，早期无介入治疗失败的患者的术后FS率显著高于有早期介入治疗失败的患者(P<；0.001)。结论：本研究提出了一个具有中等准确性的预测模型来识别早期TACE难治的高危患者，早期TACE难治的患者预后可能较差。
Objectives: To develop and validate a predictive model for early refractoriness of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: In this multicenter retrospective study, a total of 204 consecutive patients who initially underwent TACE were included. Early TACE refractoriness was defined as patients presented with TACE refractoriness after initial two consecutive TACE procedures. Of all patients, 147 patients (approximately 70%) were assigned to a training set, and the remaining 57 patients (approximately 30%) were assigned to a validation set. Predictive model was established using forward stepwise logistic regression and nomogram. Based on factors selected by logistic regression, a one-to-one propensity score matching (PSM) was conducted to compare progression-free survival (PFS) between patients who were present or absent of early TACE refractoriness. PFS curve was estimated by Kaplan-Meier method and compared by log-rank test. Results: Logistic regression revealed that bilobar tumor distribution (p = 0.002), more than three tumors (p = 0.005) and beyond up-to-seven criteria (p = 0.001) were significantly related to early TACE refractoriness. The discriminative abilities, as determined by the area under the receiver operating characteristic (ROC) curve, were 0.788 in the training cohort and 0.706 in the validation cohort. After PSM, the result showed that patients who were absent of early TACE refractoriness had a significantly higher PFS rate than those of patients who were present (p < 0.001). Conclusion: This study presents a predictive model with moderate accuracy to identify patients with high risk of early TACE refractoriness, and patients with early TACE refractoriness may have a poor prognosis.
登录
查看更多内容
影响因子：
1.4
作者：
Elmoghazy, Walid;Ahmed, Khalid;Khalaf, Hatem
通讯作者：
Khalaf, Hatem
DOI：
10.1016/j.jvir.2015.12.752
发表时间：
2016-04-01
影响因子：
2.9
作者：
Gaba, Ron C.;Lewandowski, Robert J.;Brown, Daniel B.
通讯作者：
Brown, Daniel B.
影响因子：
6.6
作者：
Kimura, Haruki;Ohkawa, Kazuyoshi;Katayama, Kazuhiro
通讯作者：
Katayama, Kazuhiro
影响因子：
4.7
作者：
Maas, Monique;Beets-Tan, Regina;Bilbao, Jose Ignacio
通讯作者：
Bilbao, Jose Ignacio
微血管侵袭作为索拉非尼和经动脉化疗栓塞治疗复发性中期肝细胞癌疗效的预测因子
影响因子：
19.7
作者：
Peng, Zhenwei;Chen, Shuling;Kuang, Ming
通讯作者：
Kuang, Ming