Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma
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.
基金:
National Natural Science Foundation of China [81672699, 81972726]
第一作者单位:[1]Hangzhou Med Coll, People Hosp, Zhejiang Prov Peoples Hosp, Dept Hepatobiliary Pancreat & Minimal Invas Surg, 158 Shangtang Rd, Hangzhou 310014, Zhejiang, Peoples R China[2]Key Lab Tumor Mol Diag & Individualized Med Zheji, Hangzhou, Peoples R China
通讯作者:
通讯机构:[1]Hangzhou Med Coll, People Hosp, Zhejiang Prov Peoples Hosp, Dept Hepatobiliary Pancreat & Minimal Invas Surg, 158 Shangtang Rd, Hangzhou 310014, Zhejiang, Peoples R China[2]Key Lab Tumor Mol Diag & Individualized Med Zheji, Hangzhou, Peoples R China[3]Navy Med Univ, Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, Shanghai, Peoples R China
推荐引用方式(GB/T 7714):
Liang Lei,Li Chao,Wang Ming-Da,et al.Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma[J].JOURNAL OF HEMATOLOGY & ONCOLOGY.2021,14(1):doi:10.1186/s13045-021-01180-5.
APA:
Liang, Lei,Li, Chao,Wang, Ming-Da,Wang, Hong,Zhou, Ya-Hao...&Yang, Tian.(2021).Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma.JOURNAL OF HEMATOLOGY & ONCOLOGY,14,(1)
MLA:
Liang, Lei,et al."Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma".JOURNAL OF HEMATOLOGY & ONCOLOGY 14..1(2021)