Department of Radiology, The Ninth People Hospital of Chongqing, No.69 Jialing Village, Beibei District, Chongqing, 400010, China.
Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Radiol Med. 2022 Sep;127(9):939-949. doi: 10.1007/s11547-022-01517-1. Epub 2022 Aug 26.
To identify the associations of clinical and magnetic resonance (MR) features with overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC) achieving complete response (CR) after conventional transcatheter arterial chemoembolization (TACE) and to further develop an individual nomograph to estimate the survival probability.
A total of 112 patients with unresectable HCC treated with TACE as first-line treatment were retrospectively evaluated. Potential risk factors associated with OS were identified by univariate and multivariate Cox analyses. The survival model was developed by multivariate Cox proportional hazard model. The area under the receiver operating characteristic curve was calculated to assess the performance of each marker and of the whole model. Discrimination was performed using Kaplan-Meier curves, and the survival curves were compared by the log-rank test. A nomogram derived from the survival model was established.
Multivariate Cox analyses indicated that nonsmooth tumor margin, peritumoral enhancement, fat sparing in solid mass, and Barcelona clinic liver cancer (BCLC) stage were independent risk indicators associated with OS. The survival model showed acceptable diagnostic power, with an area under the curve (AUC) of 0.687. Kaplan-Meier curves demonstrated that the model discriminated well, as the high-risk and low-risk groups had median survival times of 21.6 months and 34.8 months, respectively (log-rank test, P = 0.01).
Nonsmooth tumor margin, peritumoral enhancement, fat sparing in solid mass, and BCLC stage were potential biomarkers to evaluate the survival with favorable performance and discriminate HCC patients with CR under conventional TACE treatment.
确定不可切除肝细胞癌（HCC）患者经常规经导管动脉化疗栓塞（TACE）治疗后达到完全缓解（CR）的临床和磁共振（MR）特征与总生存期（OS）的相关性，并进一步开发个体列线图来估计生存概率。
回顾性评估了 112 例接受 TACE 作为一线治疗的不可切除 HCC 患者。通过单因素和多因素 Cox 分析确定与 OS 相关的潜在风险因素。通过多因素 Cox 比例风险模型建立生存模型。计算接受者操作特征曲线下面积以评估每个标志物和整个模型的性能。通过 Kaplan-Meier 曲线进行判别，通过对数秩检验比较生存曲线。从生存模型中得出一个列线图。
多因素 Cox 分析表明，肿瘤边缘不光滑、肿瘤周围增强、实体瘤内脂肪保留和巴塞罗那临床肝癌（BCLC）分期是与 OS 相关的独立风险指标。生存模型显示出可接受的诊断能力，曲线下面积（AUC）为 0.687。Kaplan-Meier 曲线表明该模型具有良好的判别能力，因为高危组和低危组的中位生存时间分别为 21.6 个月和 34.8 个月（对数秩检验，P=0.01）。
肿瘤边缘不光滑、肿瘤周围增强、实体瘤内脂肪保留和 BCLC 分期是评估经常规 TACE 治疗后 CR 的 HCC 患者具有良好性能的潜在生物标志物，并可进行区分。
