Du Li-Xin, Sheng Guo-Li, Shi An-da, Li Kang-Shuai, Liu Zeng-Li, Tang Yong-Chang, Liu Yi, Zhang Zong-Li
Department of General Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Pharmacol. 2024 Aug 21;15:1426912. doi: 10.3389/fphar.2024.1426912. eCollection 2024.
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and often arises in the context of chronic liver disease, such as hepatitis B or C infection, and cirrhosis. Advanced unresectable HCC (uHCC) presents significant treatment challenges due to its advanced stage and inoperability. One efficient treatment method for advanced uHCC is the use of hepatic arterial infusion chemotherapy (HAIC) combined with transcatheter arterial embolization (TAE).
In this study, we conducted a retrospective collection of clinical data, including basic information, radiological data, and blood test parameters, for patients with advanced uHCC who underwent TAE + HAIC treatment from August 2020 to February 2023. A total of 743 cases involving 262 patients were included. Ultimately, the covariates included in the analysis were the Child-Pugh score, extrahepatic metastasis, tumor number, tumor size, and treatment method.
In the study, we performed univariable and multivariable analysis on 23 clinical factors that were screened by LASSO regression, indicating that the five variables aforementionedly were identified as independent factors influencing patient prognosis. Then we developed a nomogram of the sensitive model and calculated concordance indices of prognostic survival models.
Based on the uHCC patient cohort, we have developed a prognostic model for OS in patients who received TAE + HAIC treatment. This model can accurately predict OS and has the potential to assist in personalized clinical decision-making.
肝细胞癌（HCC）是最常见的原发性肝癌，通常发生在慢性肝病的背景下，如乙型或丙型肝炎感染以及肝硬化。晚期不可切除的HCC（uHCC）由于其晚期阶段和不可切除性而带来了重大的治疗挑战。一种针对晚期uHCC的有效治疗方法是使用肝动脉灌注化疗（HAIC）联合经导管动脉栓塞术（TAE）。
在本研究中，我们对2020年8月至2023年2月期间接受TAE + HAIC治疗的晚期uHCC患者的临床资料进行了回顾性收集，包括基本信息、放射学数据和血液检测参数。共纳入262例患者的743个病例。最终，纳入分析的协变量包括Child-Pugh评分、肝外转移、肿瘤数量、肿瘤大小和治疗方法。
在研究中，我们对通过LASSO回归筛选出的23个临床因素进行了单变量和多变量分析，表明上述五个变量被确定为影响患者预后的独立因素。然后我们构建了敏感模型的列线图并计算了预后生存模型的一致性指数。
基于uHCC患者队列，我们为接受TAE + HAIC治疗的患者开发了一个总生存期（OS）的预后模型。该模型可以准确预测OS，并有可能协助进行个性化的临床决策。
