Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma
Background The role of adjuvant transarterial chemoembolisation (TACE) to reduce postoperative recurrence varies widely among patients undergoing hepatectomy with curative intent for hepatocellular carcinoma (HCC). Personalised predictive tool to select which patients may benefit from adjuvant TACE...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-08-01
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| Series: | eGastroenterology |
| Online Access: | https://egastroenterology.bmj.com/content/1/1/e100008.full |
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| author | Chao Li Feng Shen Wan Yee Lau Timothy M Pawlik Tian Yang Wei-Yue Chen Zhi-Peng Liu Qing-Yu Kong Li-Yang Sun Yong-Yi Zeng Ying-Jian Liang Ya-Hao Zhou Ting-Hao Chen Zi-Xiang Chen Ming-Da Wang Lan-Qing Yao Jian-Song Ji |
| author_facet | Chao Li Feng Shen Wan Yee Lau Timothy M Pawlik Tian Yang Wei-Yue Chen Zhi-Peng Liu Qing-Yu Kong Li-Yang Sun Yong-Yi Zeng Ying-Jian Liang Ya-Hao Zhou Ting-Hao Chen Zi-Xiang Chen Ming-Da Wang Lan-Qing Yao Jian-Song Ji |
| author_sort | Chao Li |
| collection | DOAJ |
| description | Background The role of adjuvant transarterial chemoembolisation (TACE) to reduce postoperative recurrence varies widely among patients undergoing hepatectomy with curative intent for hepatocellular carcinoma (HCC). Personalised predictive tool to select which patients may benefit from adjuvant TACE is lacking. This study aimed to develop and validate an online calculator for estimating the reduced risk of early recurrence from adjuvant TACE for patients with HCC.Methods From a multi-institutional database, 2590 eligible patients undergoing curative-intent hepatectomy for HCC were enrolled, and randomly assigned to the training and validation cohorts. Independent predictors of early recurrence within 1 year of surgery were identified in the training cohort, and subsequently used to construct a model and corresponding prediction calculator. The predictive performance of the model was validated using concordance indexes (C-indexes) and calibration curves, and compared with conventional HCC staging systems. The reduced risk of early recurrence when receiving adjuvant TACE was used to estimate the expected benefit from adjuvant TACE.Results The prediction model was developed by integrating eight factors that were independently associated with risk of early recurrence: alpha-fetoprotein level, maximum tumour size, tumour number, macrovascular and microvascular invasion, satellite nodules, resection margin and adjuvant TACE. The model demonstrated good calibration and discrimination in the training and validation cohorts (C-indexes: 0.799 and 0.778, respectively), and performed better among the whole cohort than four conventional HCC staging systems (C-indexes: 0.797 vs 0.562–0.673, all p<0.001). An online calculator was built to estimate the reduced risk of early recurrence from adjuvant TACE for patients with resected HCC.Conclusions The proposed calculator can be adopted to assist decision-making for clinicians and patients to determine which patients with resected HCC can significantly benefit from adjuvant TACE. |
| format | Article |
| id | doaj-art-8714c570cba64371b65a1feddb796670 |
| institution | Kabale University |
| issn | 2766-0125 2976-7296 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | eGastroenterology |
| spelling | doaj-art-8714c570cba64371b65a1feddb7966702024-12-25T14:40:10ZengBMJ Publishing GroupeGastroenterology2766-01252976-72962023-08-011110.1136/egastro-2023-100008Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinomaChao Li0Feng Shen1Wan Yee Lau2Timothy M Pawlik3Tian Yang4Wei-Yue Chen5Zhi-Peng Liu6Qing-Yu Kong7Li-Yang Sun8Yong-Yi Zeng9Ying-Jian Liang10Ya-Hao Zhou11Ting-Hao Chen12Zi-Xiang Chen13Ming-Da Wang14Lan-Qing Yao15Jian-Song Ji16Growth, Development and Mental Health Center of Children and Adolescents, Children’s Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, ChinaDepartment of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China1 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China12 Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, Ohio, USA13 Eastern Hepatobiliary Clinical Research Institute, Third Affiliated Hospital of Navy Medical University, Shanghai, China1 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China3 Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China4 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China5 Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China6 Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou, Fujian, China7 Department of Hepatobiliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China8 Department of Hepatobiliary Surgery, Pu’er People’s Hospital, Pu’er, Yunnan, China9 Department of General Surgery, Ziyang First People’s Hospital, Ziyang, Sichuan, China10 Department of Hepatobiliary Surgery, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China1 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China1 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China2 The Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research, Department of Interventional Radiology, Lishui Hospital of Zhejiang University, Lishui, Zhejiang, ChinaBackground The role of adjuvant transarterial chemoembolisation (TACE) to reduce postoperative recurrence varies widely among patients undergoing hepatectomy with curative intent for hepatocellular carcinoma (HCC). Personalised predictive tool to select which patients may benefit from adjuvant TACE is lacking. This study aimed to develop and validate an online calculator for estimating the reduced risk of early recurrence from adjuvant TACE for patients with HCC.Methods From a multi-institutional database, 2590 eligible patients undergoing curative-intent hepatectomy for HCC were enrolled, and randomly assigned to the training and validation cohorts. Independent predictors of early recurrence within 1 year of surgery were identified in the training cohort, and subsequently used to construct a model and corresponding prediction calculator. The predictive performance of the model was validated using concordance indexes (C-indexes) and calibration curves, and compared with conventional HCC staging systems. The reduced risk of early recurrence when receiving adjuvant TACE was used to estimate the expected benefit from adjuvant TACE.Results The prediction model was developed by integrating eight factors that were independently associated with risk of early recurrence: alpha-fetoprotein level, maximum tumour size, tumour number, macrovascular and microvascular invasion, satellite nodules, resection margin and adjuvant TACE. The model demonstrated good calibration and discrimination in the training and validation cohorts (C-indexes: 0.799 and 0.778, respectively), and performed better among the whole cohort than four conventional HCC staging systems (C-indexes: 0.797 vs 0.562–0.673, all p<0.001). An online calculator was built to estimate the reduced risk of early recurrence from adjuvant TACE for patients with resected HCC.Conclusions The proposed calculator can be adopted to assist decision-making for clinicians and patients to determine which patients with resected HCC can significantly benefit from adjuvant TACE.https://egastroenterology.bmj.com/content/1/1/e100008.full |
| spellingShingle | Chao Li Feng Shen Wan Yee Lau Timothy M Pawlik Tian Yang Wei-Yue Chen Zhi-Peng Liu Qing-Yu Kong Li-Yang Sun Yong-Yi Zeng Ying-Jian Liang Ya-Hao Zhou Ting-Hao Chen Zi-Xiang Chen Ming-Da Wang Lan-Qing Yao Jian-Song Ji Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma eGastroenterology |
| title | Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma |
| title_full | Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma |
| title_fullStr | Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma |
| title_full_unstemmed | Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma |
| title_short | Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma |
| title_sort | novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma |
| url | https://egastroenterology.bmj.com/content/1/1/e100008.full |
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