Construction and Validation of a Predictive Model for Post-TACE Recurrence Risk in Hepatocellular Carcinoma: A...

Area of Science:

• Hepatobiliary Surgery
• Oncology
• Medical Imaging

Background:

• Transarterial chemoembolization (TACE) is a standard treatment for unresectable hepatocellular carcinoma (HCC).
• Accurate prognostic models for HCC patients undergoing TACE are currently underutilized in clinical practice.
• Predicting recurrence and guiding treatment decisions for HCC remains a challenge.

Purpose of the Study:

• To develop and validate a prognostic nomogram for predicting recurrence in HCC patients treated with TACE.
• To identify independent predictors of recurrence after TACE for hepatocellular carcinoma.
• To assess the clinical utility of the developed nomogram compared to existing staging systems.

Main Methods:

• Retrospective analysis of 265 HCC patients who underwent TACE.
• Identification of recurrence risk factors using Cox regression and LASSO regression.
• Construction of a prognostic nomogram and evaluation using decision curve analysis (DCA).

Main Results:

• Multivariate analysis identified elevated fibrinogen (Fib) and higher China Liver Cancer (CNLC) stage as independent predictors of recurrence.
• LASSO regression selected vascular invasion, neutrophils, albumin (ALB), activated partial thromboplastin time, Fib, and alkaline phosphatase-to-albumin ratio (AAPR) as key prognostic variables.
• The nomogram demonstrated strong predictive accuracy (AUCs of 0.717, 0.794, and 0.884 at 6 months, 1 year, and 2 years, respectively) and superior clinical utility over existing systems.

Conclusions:

• The developed TACE-based prognostic nomogram accurately predicts postoperative recurrence in HCC patients.
• The nomogram enables individualized risk stratification, assisting clinicians in tailoring interventions.
• This tool supports personalized therapy decisions for hepatocellular carcinoma patients undergoing TACE.