Shen Hai-Hua, Hong Yu-Rong, Xu Wen, Chen Lei, Chen Jun-Min, Yang Zhi-Gen, Chen Cai-Hong
Department of Ultrasound, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang Province, China.
Department of Ultrasound, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
World J Gastrointest Surg. 2024 Aug 27;16(8):2630-2639. doi: 10.4240/wjgs.v16.i8.2630.
The incidence and mortality rates of primary hepatocellular carcinoma (HCC) are high, and the conventional treatment is radiofrequency ablation (RFA) with transcatheter arterial chemoembolization (TACE); however, the 3-year survival rate is still low. Further, there are no visual methods to effectively predict their prognosis.
To explore the factors influencing the prognosis of HCC after RFA and TACE and develop a nomogram prediction model.
Clinical and follow-up information of 150 patients with HCC treated using RFA and TACE in the Hangzhou Linping Hospital of Traditional Chinese Medicine from May 2020 to December 2022 was retrospectively collected and recorded. We examined their prognostic factors using multivariate logistic regression and created a nomogram prognosis prediction model using the R software (version 4.1.2). Internal verification was performed using the bootstrapping technique. The prognostic efficacy of the nomogram prediction model was evaluated using the concordance index (CI), calibration curve, and receiver operating characteristic curve.
Of the 150 patients treated with RFA and TACE, 92 (61.33%) developed recurrence and metastasis. Logistic regression analysis identified six variables, and a predictive model was created. The internal validation results of the model showed a CI of 0.882. The correction curve trend of the prognosis prediction model was always near the diagonal, and the mean absolute error before and after internal validation was 0.021. The area under the curve of the prediction model after internal verification was 0.882 [95% confidence interval (95%CI): 0.820-0.945], with a specificity of 0.828 and sensitivity of 0.656. According to the Hosmer-Lemeshow test, = 3.552 and = 0.895. The predictive model demonstrated a satisfactory calibration, and the decision curve analysis demonstrated its clinical applicability.
The prognosis of patients with HCC after RFA and TACE is affected by several factors. The developed prediction model based on the influencing parameters shows a good prognosis predictive efficacy.
原发性肝细胞癌（HCC）的发病率和死亡率较高，常规治疗方法是射频消融（RFA）联合经动脉化疗栓塞术（TACE）；然而，其3年生存率仍然较低。此外，目前尚无有效的可视化方法来预测其预后。
探讨影响RFA联合TACE治疗后HCC患者预后的因素，并建立列线图预测模型。
回顾性收集并记录2020年5月至2022年12月在杭州市临平区中医院接受RFA联合TACE治疗的150例HCC患者的临床及随访信息。采用多因素logistic回归分析其预后因素，并使用R软件（版本4.1.2）建立列线图预后预测模型。采用自抽样技术进行内部验证。使用一致性指数（CI）、校准曲线和受试者工作特征曲线评估列线图预测模型的预后效能。
150例接受RFA联合TACE治疗的患者中，92例（61.33%）出现复发和转移。logistic回归分析确定了6个变量，并建立了预测模型。模型的内部验证结果显示CI为0.882。预后预测模型的校正曲线趋势始终接近对角线，内部验证前后的平均绝对误差为0.021。内部验证后预测模型的曲线下面积为0.882 [95%置信区间（95%CI）：0.820 - 0.945]，特异性为0.828，敏感性为0.656。根据Hosmer-Lemeshow检验，χ² = 3.552，P = 0.895。预测模型显示出良好的校准效果，决策曲线分析证明了其临床适用性。
RFA联合TACE治疗的HCC患者预后受多种因素影响。基于影响参数建立的预测模型显示出良好的预后预测效能。
