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

作者：Lei Liang, Chao Li, Ming-Da Wang, Hong Wang, Ya-Hao Zhou, Yongyi Zeng, Wanguang Zhang, Ting‐Hao Chen, Nan-Ya Wang, Jie Li, Yaoming Zhang, Yu Wang, Wei‐Min Gu, Hao Xing, Yong‐Kang Diao, Wan Yee Lau, Cheng-Wu Zhang, Timothy Michael Pawlik, Feng Shen, Dong‐Sheng Huang, Tian Yang · 发表于：Journal of Hematology & Oncology · 年份：2021 · DOI：10.1186/s13045-021-01180-5 · 被引用次数：58 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Organ Transplantation Techniques and Outcomes

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 0.7...