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Postoperative adjuvant TACE-associated nomogram for predicting the prognosis of resectable Hepatocellular Carcinoma with portal vein Tumor Thrombus after Liver Resection
International Journal of Biological Sciences ( IF 8.2 ) Pub Date : 2020-10-23 , DOI: 10.7150/ijbs.46896
Fuchen Liu 1 , Xinggang Guo 1, 2 , Wei Dong 1 , Wenli Zhang 1 , Shuxun Wei 3 , Shutong Zhang 4 , Xiuli Zhu 5 , Weiping Zhou 1 , Jinmin Zhang 6 , Hui Liu 1
Affiliation  

Background: To explore the effects of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of HCC patients with Portal Vein Tumor Thrombus (PVTT) undergoing resection, and to develop a PA-TACE-related nomogram for predicting survival individually./nPatients and Methods: Two hundred and ninety-three consecutive HCC patients with PVTT under R0 hepatectomy were recruited. Forty-seven cases had recurrence within one month after surgery. The remaining 246 cases consisted of 90 PA-TACE and 156 non-PA-TACE cases. COX regression analysis was performed for overall survival (OS) or recurrence-free survival (RFS) of these 246 cases, allowing the derivation of independent factors that were integrated into the nomogram. C-index, calibration curves, and risk stratification were performed to evaluate the performance and discriminative power of the nomograms./nResults: In 246 patients without recurrence within one month after surgery, the OS and RFS for the PA-TACE group were significantly better than those for the non-PA-TACE group (P<0.0001, P<0.0001, respectively). After Cox regression analysis of OS or RFS, PA-TACE-related nomogram models were constructed. The C-index of the PA-TACE-related nomogram for OS and RFS was 0.72 and 0.73, respectively. Calibration curves revealed a good agreement between predictions and observations for the nomograms. Based on the nomogram-related risk stratification, Kaplan-Meier curves showed powerful discriminative ability./nConclusions: PA-TACE therapy improved the survival of HCC patients with PVTT undergoing hepatectomy. Accurate nomogram models were developed for predicting the individual survival and recurrence of these patients.

中文翻译:

术后辅助 TACE 相关列线图预测可切除肝细胞癌伴门静脉癌栓肝切除术后预后

背景:探讨术后辅助经动脉化疗栓塞 (PA-TACE) 对行门静脉癌栓 (PVTT) 切除术的 HCC 患者预后的影响,并开发 PA-TACE 相关列线图以预测个体生存率。/n患者和方法:招募了 293 名在 R0 肝切除术下进行 PVTT 的连续 HCC 患者。术后1个月内复发47例。其余 246 例包括 90 例 PA-TACE 和 156 例非 PA-TACE。对这 246 例病例的总生存期 (OS) 或无复发生存期 (RFS) 进行 COX 回归分析,从而推导出整合到列线图中的独立因素。执行 C 指数、校准曲线和风险分层以评估列线图的性能和判别力。/n结果:术后 1 个月内未复发的 246 例患者中,PA-TACE 组的 OS 和 RFS 显着优于非 PA-TACE 组(分别为 P<0.0001、P<0.0001)。OS或RFS的Cox回归分析后,构建PA-TACE相关列线图模型。OS 和 RFS 的 PA-TACE 相关列线图的 C 指数分别为 0.72 和 0.73。校准曲线显示诺模图的预测和观察之间有很好的一致性。基于列线图相关的风险分层,Kaplan-Meier 曲线显示出强大的判别能力。/n结论: PA-TACE 治疗提高了接受肝切除术的 PVTT 的 HCC 患者的生存率。开发了准确的列线图模型来预测这些患者的个体存活率和复发率。
更新日期:2020-10-30
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