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. 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. 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. 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.

中文翻译：

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一种新型在线计算器的开发和验证，用于估计肝细胞癌手术患者辅助经导管动脉化疗栓塞的生存获益

尽管经导管动脉化疗栓塞 (TACE) 用于切除肝细胞癌 (HCC) 的辅助治疗可能会提高某些患者的生存率，但确定哪些患者可以受益仍然具有挑战性。本研究旨在构建一个生存预测计算器，用于个体化估计辅助 TACE 对切除的 HCC 患者的净生存获益。从多中心数据库中，连续招募了接受 HCC 根治性切除术的患者，并将其分为开发组和验证组。使用开发队列中的独立生存预测因子，分别为有和没有辅助 TACE 的患者构建了两个列线图模型，通过测量一致性指数 (C-index) 和校准在内部和外部验证了预测性能。预测模型的两个估计值之间的差异是辅助 TACE 的预期生存获益。共有 2514 名患者符合该研究的纳入标准。有和无辅助 TACE 患者的列线图预测模型分别通过纳入相同的 8 个独立生存预测因子建立，包括门脉高压、Child-Pugh 评分、甲胎蛋白水平、肿瘤大小和数量、大血管和微血管侵犯，以及切除边缘。这两个预测模型显示出良好的校准和辨别力，在开发和验证队列中所有 C 指数都大于 0.75。生成了一个基于浏览器的计算器，用于个性化估计辅助 TACE 的净生存获益。基于大规模真实世界数据，