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| The effect of adjuvant transarterial chemoembolization for hepatocellular carcinoma after liver resection based on risk stratification |
| Jin-Shu Zeng a , b , # , Jian-Xing Zeng b , c , d , # , Yao Huang b , c , d , Jing-Feng Liu b , c , d , Jin-Hua Zeng b , c , d , ∗ |
a Department of Ultrasonic Medical, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
b The Liver Center of Fujian Province, Fujian Medical University, Fuzhou 350025, China
c Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
d Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350005, China
∗Corresponding author at: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
E-mail address: zengjinhua1207@hotmail.com (J.-H. Zeng).
# Contributed equally. |
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Abstract Background: There is currently no standard adjuvant treatment proven to prevent hepatocellular carcinoma (HCC) recurrence. Recent studies suggest that postoperative adjuvant transarterial chemoembolization (PA-TACE) is beneficial for patients at high risk of tumor recurrence. However, it is difficult to select the patients. The present study aimed to develop an easy-to-use score to identify these patients.
Methods: A total of 4530 patients undergoing liver resection were recruited. Independent risk factors were identified by Cox regression model in the training cohort and the Primary liver cancer big data transarterial chemoembolization (PDTE) scoring system was established.
Results: The scoring system was composed of ten risk factors including alpha-fetoprotein (AFP), albumin-bilirubin (ALBI) grade, operative bleeding loss, resection margin, tumor capsular, satellite nodules, tumor size and number, and microvascular and macrovascular invasion. Using 5 points as risk stratification, the patients with PA-TACE had higher recurrence-free survival (RFS) compared with non-TACE in > 5 points group ( P < 0.001), whereas PA-TACE patients had lower RFS compared with non-TACE in ≤5 points group ( P = 0.013). In the training and validation cohorts, the C-indexes of PDTE scoring system were 0.714 [standard errors (SE) = 0.010] and 0.716 (SE = 0.018), respectively.
Conclusions: The model is a simple tool to identify PA-TACE for HCC patients after liver resection with a favorable performance. Patients with > 5 points may benefit from PA-TACE.
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2023, Vol. 22 
