Selection Between Liver Resection Versus Transarterial Chemoembolization in Hepatocellular Carcinoma: A Multicenter...

Area of Science:

• Hepatobiliary surgery
• Interventional radiology
• Oncology

Background:

• Hepatocellular carcinoma (HCC) treatment selection between liver resection (LR) and transarterial chemoembolization (TACE) is challenging.
• Developing predictive models is crucial for optimizing patient outcomes.

Purpose of the Study:

• To develop and validate a noninvasive model predicting progression-free survival (PFS) difference between LR and TACE for HCC.
• To assist clinicians in making individualized treatment choices.

Main Methods:

• A cohort of 520 HCC patients was divided into training and validation sets.
• A predictive model incorporating clinical, radiological, and radiomic features was constructed.
• Model performance was compared against four state-of-the-art models.

Main Results:

• The developed model demonstrated good discrimination and calibration for predicting 1-, 2-, and 3-year PFS (AUCs 0.75-0.80).
• The model outperformed four other state-of-the-art models in accuracy.
• A nomogram classified patients into subgroups where LR offered significantly longer PFS versus similar PFS between LR and TACE.

Conclusions:

• An individualized predictive model for PFS difference between LR and TACE in HCC is proposed.
• This model can aid in selecting the optimal treatment strategy for individual patients.
• The findings support personalized treatment approaches for hepatocellular carcinoma.