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

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机构: [1]Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery,Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou MedicalCollege, No.158, Shangtang Road, Hangzhou 310014, Zhejiang, China [2]Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicineof Zhejiang Province, Hangzhou, China [3]Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital, Second Military Medical University(Navy Medical University), Shanghai, China [4]Department of General Surgery,Liuyang People’s Hospital, Hunan, China [5]Department of HepatobiliarySurgery, Pu’er People’s Hospital, Yunnan, China [6]Department of HepatobiliarySurgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fujian,China [7]Department of Hepatic Surgery, Tongji Hospital, Huazhong Universityof Science and Technology, Wuhan, China [8]Department of General Surgery,Ziyang First People’s Hospital, Sichuan, China [9]The Cancer Center, the FirstHospital of Jilin University, Jilin, China [10]Department of Hepatobiliary Surgery,Fuyang People’s Hospital, Anhui, China [11]The Second Department of HepatobiliarySurgery, Meizhou People’s Hospital, Guangdong, China [12]Departmentof Hepatobiliary Surgery, Chongqing University Cancer Hospital, Chongqing,China [13]The First Department of General Surgery, The Fourth Hospital of Harbin,Heilongjiang, China [14]Faculty of Medicine, The Chinese University of HongKong, Shatin, New Territories, Hong Kong, China [15]Department of Surgery,Ohio State University, Wexner Medical Center, Columbus, OH, USA [16]Schoolof Clinical Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, China
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关键词: Hepatocellular carcinoma Hepatectomy Transcatheter arterial chemoembolization Adjuvant therapy Survival

摘要:
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.

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出版当年[2021]版:
大类 | 1 区 医学
小类 | 1 区 血液学 1 区 肿瘤学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 血液学 1 区 肿瘤学
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出版当年[2020]版:
Q1 HEMATOLOGY Q1 ONCOLOGY
最新[2023]版:
Q1 HEMATOLOGY Q1 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery,Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou MedicalCollege, No.158, Shangtang Road, Hangzhou 310014, Zhejiang, China [2]Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicineof Zhejiang Province, Hangzhou, China
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通讯机构: [1]Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery,Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou MedicalCollege, No.158, Shangtang Road, Hangzhou 310014, Zhejiang, China [2]Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicineof Zhejiang Province, Hangzhou, China [3]Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital, Second Military Medical University(Navy Medical University), Shanghai, China
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