Prognostic Prediction and Risk Stratification of Transarterial Chemoembolization Combined with Targeted Therapy and Immunotherapy for Unresectable Hepatocellular Carcinoma: A Dual-Center Study

作者：Wendi Kang, Huafei Zhao, Qicai Lian, Hang Li, Xuan Zhou, Hao Li, Siyuan Weng, Zhentao Yan, Zhengqiang Yang · 发表于：Journal of Hepatocellular Carcinoma · 年份：2024 · DOI：10.2147/jhc.s487080 · 被引用次数：5 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Multiple and Secondary Primary Cancers

Purpose: The combination of transarterial chemoembolization, molecular targeted therapy, and immunotherapy (triple therapy) has shown promising outcomes in the treatment of unresectable hepatocellular carcinoma (HCC). This study aimed to build a prognostic model to identify patients who could benefit from triple therapy. Patients and Methods: This retrospective study encompassed 242 patients with HCC who underwent triple therapy from two centers (Training cohort: 158 patients from the Center 1; External validation cohort: 84 patients from the Center 2). Independent predictors of overall survival (OS) and progression-free survival (PFS) were identified through Cox regression analyses, and prognostic models based on Cox proportional hazards models were developed. Prognosis was assessed using Kaplan - Meier curves. Results: In the training cohort, independent predictors of PFS included vascular invasion and the C-reactive protein and alpha-fetoprotein in immunotherapy (CRAFITY) score. Independent predictors of OS were the CRAFITY score, extrahepatic metastasis, and the neutrophil-to-lymphocyte ratio. Prognostic prediction models were constructed based on these variables. The prognostic model for OS demonstrated a C-index of 0.715 (95% confidence interval (CI), 0.662-0.768) in the training cohort and 0.701 (95% CI, 0.628-0.774) in the validation cohort. Patients were divided into low- and high-risk categories using the predictive model (P<0.001). These findings were corroborated ...