Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma

Journal of Hematology & Oncology

Hong Wang¹  Ting-Hao Chen²  Wan-Guang Zhang³  Yu Wang⁴  Wan Yee Lau⁵  Feng Shen⁵  Chao Li⁵  Ming-Da Wang⁵  Hao Xing⁵  Jie Li⁶  Yong-Yi Zeng⁷  Ya-Hao Zhou⁸  Cheng-Wu Zhang⁹  Tian Yang⁹  Yong-Kang Diao⁹  Lei Liang⁹  Timothy M. Pawlik^1,10  Dong-Sheng Huang^1,11  Nan-Ya Wang^1,12  Wei-Min Gu^1,13  Yao-Ming Zhang^1,14 

[1] Department of General Surgery, Liuyang People’s Hospital;Department of General Surgery, Ziyang First People’s Hospital;Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and Technology;Department of Hepatobiliary Surgery, Chongqing University Cancer Hospital;Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University);Department of Hepatobiliary Surgery, Fuyang People’s Hospital;Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University;Department of Hepatobiliary Surgery, Pu’er People’s Hospital;Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou Medical College;Department of Surgery, Ohio State University;Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province;The Cancer Center, the First Hospital of Jilin University;The First Department of General Surgery, The Fourth Hospital of Harbin;The Second Department of Hepatobiliary Surgery, Meizhou People’s Hospital;

关键词: Hepatocellular carcinoma;    Hepatectomy;    Transcatheter arterial chemoembolization;    Adjuvant therapy;    Survival;   

DOI  :  10.1186/s13045-021-01180-5

来源: DOAJ

【 摘 要 】

Abstract Background and aims Although adjuvant transcatheter arterial chemoembolization (TACE) for resected hepatocellular carcinoma (HCC) may improve survival for some patients, identifying which patients can benefit remains challenging. The present study aimed to construct a survival prediction calculator for individualized estimating the net survival benefit of adjuvant TACE for patients with resected HCC. Methods From a multicenter database, consecutive patients undergoing curative resection for HCC were enrolled and divided into the developing and validation cohorts. Using the independent survival predictors in the developing cohort, two nomogram models were constructed for patients with and without adjuvant TACE, respectively, which predictive performance was validated internally and externally by measuring concordance index (C-index) and calibration. The difference between two estimates of the prediction models was the expected survival benefit of adjuvant TACE. Results A total of 2514 patients met the inclusion criteria for the study. The nomogram prediction models for patients with and without adjuvant TACE were, respectively, built by incorporating the same eight independent survival predictors, including portal hypertension, Child–Pugh score, alpha-fetoprotein level, tumor size and number, macrovascular and microvascular invasion, and resection margin. These two prediction models demonstrated good calibration and discrimination, with all the C-indexes of greater than 0.75 in the developing and validation cohorts. A browser-based calculator was generated for individualized estimating the net survival benefit of adjuvant TACE. Conclusions Based on large-scale real-world data, an easy-to-use online calculator can be adopted as a decision aid to predict which patients with resected HCC can benefit from adjuvant TACE.

【 授权许可】

Unknown