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Development of a Nomogram for Prognostic Prediction of Large Hepatocellular Carcinoma With HBV After TACE Combined Conversion Therapy

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Název: Development of a Nomogram for Prognostic Prediction of Large Hepatocellular Carcinoma With HBV After TACE Combined Conversion Therapy
Autoři: Xu W, Ding X, Xu Y, Zhang Y, Xu H, Guo L, Li L
Zdroj: Hepat Med
Hepatic Medicine: Evidence and Research, Vol Volume 17, Pp 1-12 (2025)
Informace o vydavateli: Informa UK Limited, 2025.
Rok vydání: 2025
Témata: nomogram, surgical resection, hepatocellular carcinoma, transarterial chemoembolization, RC799-869, Diseases of the digestive system. Gastroenterology, conversion therapy, Original Research
Popis: Surgical resection (SR) following transarterial chemoembolization (TACE) is a promising option for large hepatocellular carcinoma (LHCC) with HBV, and identification of these patients at high-risk of prognosis may help individualized treatment.To develop and validate pre- and postoperative prognostic nomograms integrating clinico-therapeutic-pathological features for predicting overall survival (OS) after TACE combined therapy.Between May 2010 and October 2021, 255 consecutive patients with LHCC receiving conversion therapy of TACE combined with Lenvatinib plus PD-1 inhibitors were included from three tertiary-care hospitals. In the derivation cohort (n=201), the Cox regression analysis for developing nomograms for OS (time from initial TACE to death). In the testing cohort (n = 54), two models' performance was compared with five major staging systems.The preoperative nomogram included alpha-fetoprotein (AFP, HR: 0.486; 95% CI: 0.266-0.886; P = 0.019) and albumin- bilirubin (ALBI) grade (HR: 0.323; 95% CI: 0.181-0.578; P < 0.001) and the postoperative nomogram, included AFP (HR: 0.501; 95% CI: 0.271-0.925; P = 0.027), ALBI grade (HR: 0.356; 95% CI: 0.192-0.659; P = 0.001), MVI (HR: 0.086; 95% CI: 0.024-0.192; P < 0.001), and response to TACE combined therapy (HR: 3.367; 95% CI: 1.479-7.721; P = 0.004). The testing dataset C-indexes of the pre- (0.715) and postoperative (0.912) nomograms were higher than all five staging systems (0.589-0.483; all P < 0.001). Two prognostically distinct risk strata were identified according to these nomograms (all P < 0.001).Based on 255 patients receiving TACE combined conversion therapy for LHCC, we developed and validated two nomograms for predicting OS, with superior performances than five major staging systems and effective survival stratification.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1179-1535
DOI: 10.2147/hmer.s481334
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/40226358
https://doaj.org/article/1410b639295747959396e24163aeadab
Rights: CC BY NC
URL: http://creativecommons.org/licenses/by-nc/4.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at http://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License (http://creativecommons.org/licenses/by-nc/4.0/ (http://creativecommons.org/licenses/by-nc/4.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (http://www.dovepress.com/terms.php).
Přístupové číslo: edsair.doi.dedup.....5f1359a4eb28296b3e4a50dbbe2eb645
Databáze: OpenAIRE
Popis
Abstrakt:Surgical resection (SR) following transarterial chemoembolization (TACE) is a promising option for large hepatocellular carcinoma (LHCC) with HBV, and identification of these patients at high-risk of prognosis may help individualized treatment.To develop and validate pre- and postoperative prognostic nomograms integrating clinico-therapeutic-pathological features for predicting overall survival (OS) after TACE combined therapy.Between May 2010 and October 2021, 255 consecutive patients with LHCC receiving conversion therapy of TACE combined with Lenvatinib plus PD-1 inhibitors were included from three tertiary-care hospitals. In the derivation cohort (n=201), the Cox regression analysis for developing nomograms for OS (time from initial TACE to death). In the testing cohort (n = 54), two models' performance was compared with five major staging systems.The preoperative nomogram included alpha-fetoprotein (AFP, HR: 0.486; 95% CI: 0.266-0.886; P = 0.019) and albumin- bilirubin (ALBI) grade (HR: 0.323; 95% CI: 0.181-0.578; P < 0.001) and the postoperative nomogram, included AFP (HR: 0.501; 95% CI: 0.271-0.925; P = 0.027), ALBI grade (HR: 0.356; 95% CI: 0.192-0.659; P = 0.001), MVI (HR: 0.086; 95% CI: 0.024-0.192; P < 0.001), and response to TACE combined therapy (HR: 3.367; 95% CI: 1.479-7.721; P = 0.004). The testing dataset C-indexes of the pre- (0.715) and postoperative (0.912) nomograms were higher than all five staging systems (0.589-0.483; all P < 0.001). Two prognostically distinct risk strata were identified according to these nomograms (all P < 0.001).Based on 255 patients receiving TACE combined conversion therapy for LHCC, we developed and validated two nomograms for predicting OS, with superior performances than five major staging systems and effective survival stratification.
ISSN:11791535
DOI:10.2147/hmer.s481334