Jiang Bo, Lu Dong, Dai Jiaying, Li Kunfeng, Du Qianqian, Xie Bo, Xie Jun, Zhu Xianhai, Xie Xiang
Department of Interventional Ultrasound, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230022, People's Republic of China.
Department of Interventional Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences & Medicine, University of Science & Technology of China, Hefei, 230001, People's Republic of China.
J Hepatocell Carcinoma. 2024 Jul 10;11:1403-1414. doi: 10.2147/JHC.S458657. eCollection 2024.
To develop a simple and effective prognostic scoring system to predict the efficacy of drug-eluting bead-transcatheter arterial chemoembolization (DEB-TACE) in the treatment of hepatocellular carcinoma (HCC).
Data were retrospectively collected from 230 patients with HCC who received DEB-TACE treatment at six medical centers between January 2019 and December 2022. We developed a predictive score based on independent risk factors for overall survival (OS), validated the model using a validation cohort, and compared its prognostic accuracy with commonly used HCC staging systems.
The number of tumors, albumin-bilirubin levels, alpha-fetoprotein levels, and portal vein thrombus grade were identified as independent factors influencing OS. Based on these factors, we established the DEB-TACE treatment of HCC (DTH) scoring system. The DTH score correlated well with OS, which decreased as the DTH score increased. According to the DTH score, patients were categorized into three risk groups: low-risk (DTH-A, 0-4 points), medium-risk (DTH-B, 5-6 points), and high-risk (DTH-A, 7 points). The OS of each risk group was 18.73±0.62 months, 12.73±0.10 months, and 6.93±0.19 months, respectively (p<0.001). The external cohort validation confirmed the accuracy of the DTH score, demonstrating superior predictive performance compared to other commonly used HCC scoring systems.
The DTH-HCC scoring system effectively predicts the outcomes of HCC patients undergoing DEB-TACE as initial treatment. This model can aid in the initial planning and decision-making process for DEB-TACE treatment in HCC patients.
建立一种简单有效的预后评分系统，以预测载药微球经导管动脉化疗栓塞术（DEB-TACE）治疗肝细胞癌（HCC）的疗效。
回顾性收集2019年1月至2022年12月期间在六个医疗中心接受DEB-TACE治疗的230例HCC患者的数据。我们基于总生存期（OS）的独立危险因素制定了一个预测评分，使用验证队列对该模型进行验证，并将其预后准确性与常用的HCC分期系统进行比较。
肿瘤数量、白蛋白-胆红素水平、甲胎蛋白水平和门静脉血栓分级被确定为影响OS的独立因素。基于这些因素，我们建立了HCC的DEB-TACE治疗（DTH）评分系统。DTH评分与OS密切相关，随着DTH评分的增加而降低。根据DTH评分，患者被分为三个风险组：低风险（DTH-A，0-4分）、中风险（DTH-B，5-6分）和高风险（DTH-A，7分）。各风险组的OS分别为18.73±0.62个月、12.73±0.10个月和6.93±0.19个月（p<0.001）。外部队列验证证实了DTH评分的准确性，显示出比其他常用的HCC评分系统更好的预测性能。
DTH-HCC评分系统有效地预测了接受DEB-TACE作为初始治疗的HCC患者的预后。该模型有助于HCC患者DEB-TACE治疗的初始规划和决策过程。
