Liver Transplantation Center and HBP Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
School of Stomatology, Guizhou Medical University, Guiyang, China.
J Cancer Res Clin Oncol. 2023 Dec;149(18):16461-16471. doi: 10.1007/s00432-023-05413-7. Epub 2023 Sep 14.
Transarterial chemoembolization (TACE), one of the most commonly used postoperative adjuvant therapy for HCC, has achieved satisfactory outcomes. This study aimed to explore the prognostic value of lung immune prognostic index (LIPI) and develop a novel nomogram for recurrence-free survival (RFS) of HCC patients received postoperative adjuvant TACE (PA-TACE).
The prognostic value of LIPI was evaluated by C-index, receiver operating characteristic (ROC) analysis, and Kaplan-Meier survival curve. An effective nomogram based on preoperative prognostic factors was established from multivariate analysis and validated in the validation cohort.
The ROC and survival analysis demonstrated that the LIPI exhibited better prediction performance of HCC recurrence than other inflammatory biomarkers. According to univariate and multivariate analysis, LIPI, followed by AFP, MVI and age, were significant independent predictors for HCC recurrence and were utilized to construct the nomogram. The C-indexes of the nomogram were 0.746 (95% CI 0.721-0.770) and 0.738 (95% CI 0.701-0.775) in the training and validation cohort, respectively. The AUCs for the 1-, 2-, and 3-year RFS were 0.799, 0.867 and 0.884 in the training cohort and 0.798, 0.779 and 0.770 in the validation cohort, respectively. The calibration curves presented good consistencies. Moreover, compared with the LIPI and other clinical staging system, the established nomogram presented better prognostic performance.
Preoperative LIPI might be a powerful predictor for RFS in HCC patients received PA-TACE. The LIPI-based nomogram could further effectively predict the risk of recurrence and help clinicians formulate personalized follow-up strategies and adjuvant therapy to improve patient outcomes.
经动脉化疗栓塞术（TACE）是 HCC 最常用的术后辅助治疗方法之一，已取得满意的效果。本研究旨在探讨肺免疫预后指数（LIPI）的预后价值，并为接受术后辅助 TACE（PA-TACE）的 HCC 患者建立新的无复发生存（RFS）预测模型。
采用 C 指数、受试者工作特征（ROC）分析和 Kaplan-Meier 生存曲线评估 LIPI 的预后价值。采用多因素分析建立基于术前预后因素的有效预测模型，并在验证队列中进行验证。
ROC 和生存分析表明，LIPI 对 HCC 复发的预测性能优于其他炎症标志物。单因素和多因素分析显示，LIPI 以及 AFP、MVI 和年龄是 HCC 复发的独立预测因素，用于构建预测模型。该模型在训练和验证队列中的 C 指数分别为 0.746（95%CI：0.721-0.770）和 0.738（95%CI：0.701-0.775）。训练队列中 1、2、3 年 RFS 的 AUC 分别为 0.799、0.867 和 0.884，验证队列中分别为 0.798、0.779 和 0.770。校准曲线一致性较好。此外，与 LIPI 和其他临床分期系统相比，该预测模型具有更好的预后预测性能。
术前 LIPI 可能是预测 HCC 患者接受 PA-TACE 后 RFS 的有力指标。基于 LIPI 的预测模型可进一步有效预测复发风险，有助于临床医生制定个体化随访策略和辅助治疗方案，改善患者预后。
