Development and validation of the NTAA prognostic model for BCLC stage B hepatocellular carcinoma undergoing transarterial chemoembolization: a retrospective multicenter cohort study.
作者信息
Chen Shuanggang, Shen Lujun, Lin Letao, Qi Han, Chang Boyang, Zeng Qi, Lu Linbin, Huang Jingjun, Tan Hongtong, Cao Fei, Xie Lin, Huang Tao, Wu Ying, Wen Chunyong, Wang Yujia, Tang Ruizhi, Li Chen, Zheng Guanglei, Nuerhashi Gulijiayina, Fan Weijun
机构信息
Department of Minimally Invasive Interventional Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
出版信息
Int J Surg. 2025 Aug 7. doi: 10.1097/JS9.0000000000003138.
OBJECTIVE
Our aim was to establish a valid new prognostic predictive tool for assessing the outcomes after TACE treatment in hepatocellular carcinoma (HCC) patients with Child-Pugh A at Barcelona clinical liver cancer stage B (BCLC B) undergoing transarterial chemoembolization (TACE).
METHODS AND MATERIALS
We retrospectively analyzed 2529 HBV-related BCLC B HCC patients with Child-Pugh grade A who received initial TACE treatment, with 1075 in the primary cohort, 1076 in the internal validation cohort, and the remaining 378 in the multicenter external validation cohort. The NTAA prognostic model were constructed by Cox proportional hazards regression. The prognostic prediction performance of NTAA prognostic model with AJCC staging and other criterion were compared by time-dependent ROC and C-index. In addition, we included 305 patients of non-HBV-related BCLC stage B HCC who received TACE treatment in our center to further validate the predictive performance of the NTAA model.
RESULTS
Tumor size, tumor number, alpha-fetoprotein level, and albumin-bilirubin grade were found to be independent factors affecting overall survival (OS) after TACE in these patients. The NTAA prognostic model established accordingly divided patients into low-risk, intermediate-risk, and high-risk groups, with a median survival of 68.1, 35.7 and 15.4 months, respectively. Time-dependent ROC and C-index showed that the NTAA prognostic model was better than other existing criterion and AJCC staging in predicting OS, especially in predicting early OS rates. Furthermore, the NTAA criteria was validated in both internal validation cohort, multi-center external validation cohort, and non-HBV-related HCC cohort.
CONCLUSION
The proposed NTAA prognostic prediction model provide more accurate prognosis prediction of BCLC B HCC patients with Child-Pugh A who received TACE. The implementation of this model promises to improve the clinical decision-making process and provide more personalized treatment options for patients.
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