Development and Validation of a Risk Prediction Algorithm for Evaluating the Efficacy of Postoperative Adjuvant TACE Therapy for Hepatocellular Carcinoma


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Abstract

Background and Purpose:There is a lack of a reliable outcome prediction model for patients evaluating the feasibility of postoperative adjuvant transarterial chemoembolization (PATACE) therapy. Our goal was to develop an easy-to-use tool specifically for these patients

Methods:From January 2013 to June 2017, patients with hepatocellular carcinoma from the Liver Center of the First Affiliated Hospital of Chongqing Medical University received postoperative adjuvant Transarterial chemoembolization (TACE) therapy after liver cancer resection. A Cox proportional hazards model was established for these patients, followed by internal validation (enhanced bootstrap resampling technique) to further evaluate the predictive performance and discriminanceevaluate the predictive performance and discriminance, and compare it with other predictive models. The prognostic factors considered included tumour number, maximum tumor diameter, Edmondson-Steiner (ES) grade, Microvascular invasion (MVI) grade, Ki67, age, sex, hepatitis B surface antigen, cirrhosis, Alpha-fetoprotein (AFP), Albumin-bilirubin (ALBI) grade, Childpugh grade, body mass index (BMI), Neutrophil-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR).

Results:The endpoint of the study was overall survival. The median overall survival was 36 (95%CI: 34.0-38.0) months, with 1-year, 2-year and 3-year survival rates being 96.3%, 84.0% and 75.3%, respectively. Tumour number, MVI grade, and BMI was incorporated into the model, which had good differentiation and accuracy. Internal validation (enhanced bootstrap) suggested that Harrell’s C statistic is 0.72. The model consistently outperforms other currently available models.

Conclusion:This model may be an easy-to-use tool for screening patients suitable for PA-TACE treatment and guiding the selection of clinical protocols. But further research and external validation are required.

About the authors

Jie Tao

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Xiaoli Shi

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Xu Feng

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Xinhua Wu

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Shiguai Qi

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Guoying Feng

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Xu Yang

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Yufei Zhao

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Hangjia Zuo

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Email: info@benthamscience.net

Zhengrong Shi

Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University

Author for correspondence.
Email: info@benthamscience.net

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