Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma
Abstract Background and aims Although adjuvant transcatheter arterial chemoembolization (TACE) for resected hepatocellular carcinoma (HCC) may improve survival for some patients, identifying which patients can benefit remains challenging. The present study aimed to construct a survival prediction ca...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Hematology & Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13045-021-01180-5 |
| _version_ | 1819148353555922944 |
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| author | Lei Liang Chao Li Ming-Da Wang Hong Wang Ya-Hao Zhou Yong-Yi Zeng Wan-Guang Zhang Ting-Hao Chen Nan-Ya Wang Jie Li Yao-Ming Zhang Yu Wang Wei-Min Gu Hao Xing Yong-Kang Diao Wan Yee Lau Cheng-Wu Zhang Timothy M. Pawlik Feng Shen Dong-Sheng Huang Tian Yang |
| author_facet | Lei Liang Chao Li Ming-Da Wang Hong Wang Ya-Hao Zhou Yong-Yi Zeng Wan-Guang Zhang Ting-Hao Chen Nan-Ya Wang Jie Li Yao-Ming Zhang Yu Wang Wei-Min Gu Hao Xing Yong-Kang Diao Wan Yee Lau Cheng-Wu Zhang Timothy M. Pawlik Feng Shen Dong-Sheng Huang Tian Yang |
| author_sort | Lei Liang |
| collection | DOAJ |
| description | Abstract Background and aims Although adjuvant transcatheter arterial chemoembolization (TACE) for resected hepatocellular carcinoma (HCC) may improve survival for some patients, identifying which patients can benefit remains challenging. The present study aimed to construct a survival prediction calculator for individualized estimating the net survival benefit of adjuvant TACE for patients with resected HCC. Methods From a multicenter database, consecutive patients undergoing curative resection for HCC were enrolled and divided into the developing and validation cohorts. Using the independent survival predictors in the developing cohort, two nomogram models were constructed for patients with and without adjuvant TACE, respectively, which predictive performance was validated internally and externally by measuring concordance index (C-index) and calibration. The difference between two estimates of the prediction models was the expected survival benefit of adjuvant TACE. Results A total of 2514 patients met the inclusion criteria for the study. The nomogram prediction models for patients with and without adjuvant TACE were, respectively, built by incorporating the same eight independent survival predictors, including portal hypertension, Child–Pugh score, alpha-fetoprotein level, tumor size and number, macrovascular and microvascular invasion, and resection margin. These two prediction models demonstrated good calibration and discrimination, with all the C-indexes of greater than 0.75 in the developing and validation cohorts. A browser-based calculator was generated for individualized estimating the net survival benefit of adjuvant TACE. Conclusions Based on large-scale real-world data, an easy-to-use online calculator can be adopted as a decision aid to predict which patients with resected HCC can benefit from adjuvant TACE. |
| first_indexed | 2024-12-22T13:44:22Z |
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| id | doaj.art-d7d1ca1eceb04c829d6f65e0091460b3 |
| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-12-22T13:44:22Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj.art-d7d1ca1eceb04c829d6f65e0091460b32022-12-21T18:23:51ZengBMCJournal of Hematology & Oncology1756-87222021-10-011411610.1186/s13045-021-01180-5Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinomaLei Liang0Chao Li1Ming-Da Wang2Hong Wang3Ya-Hao Zhou4Yong-Yi Zeng5Wan-Guang Zhang6Ting-Hao Chen7Nan-Ya Wang8Jie Li9Yao-Ming Zhang10Yu Wang11Wei-Min Gu12Hao Xing13Yong-Kang Diao14Wan Yee Lau15Cheng-Wu Zhang16Timothy M. Pawlik17Feng Shen18Dong-Sheng Huang19Tian Yang20Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou Medical CollegeDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University)Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University)Department of General Surgery, Liuyang People’s HospitalDepartment of Hepatobiliary Surgery, Pu’er People’s HospitalDepartment of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical UniversityDepartment of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and TechnologyDepartment of General Surgery, Ziyang First People’s HospitalThe Cancer Center, the First Hospital of Jilin UniversityDepartment of Hepatobiliary Surgery, Fuyang People’s HospitalThe Second Department of Hepatobiliary Surgery, Meizhou People’s HospitalDepartment of Hepatobiliary Surgery, Chongqing University Cancer HospitalThe First Department of General Surgery, The Fourth Hospital of HarbinDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University)Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou Medical CollegeDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University)Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou Medical CollegeDepartment of Surgery, Ohio State UniversityDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University)Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang ProvinceDepartment of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’ Hospital of Hangzhou Medical CollegeAbstract Background and aims Although adjuvant transcatheter arterial chemoembolization (TACE) for resected hepatocellular carcinoma (HCC) may improve survival for some patients, identifying which patients can benefit remains challenging. The present study aimed to construct a survival prediction calculator for individualized estimating the net survival benefit of adjuvant TACE for patients with resected HCC. Methods From a multicenter database, consecutive patients undergoing curative resection for HCC were enrolled and divided into the developing and validation cohorts. Using the independent survival predictors in the developing cohort, two nomogram models were constructed for patients with and without adjuvant TACE, respectively, which predictive performance was validated internally and externally by measuring concordance index (C-index) and calibration. The difference between two estimates of the prediction models was the expected survival benefit of adjuvant TACE. Results A total of 2514 patients met the inclusion criteria for the study. The nomogram prediction models for patients with and without adjuvant TACE were, respectively, built by incorporating the same eight independent survival predictors, including portal hypertension, Child–Pugh score, alpha-fetoprotein level, tumor size and number, macrovascular and microvascular invasion, and resection margin. These two prediction models demonstrated good calibration and discrimination, with all the C-indexes of greater than 0.75 in the developing and validation cohorts. A browser-based calculator was generated for individualized estimating the net survival benefit of adjuvant TACE. Conclusions Based on large-scale real-world data, an easy-to-use online calculator can be adopted as a decision aid to predict which patients with resected HCC can benefit from adjuvant TACE.https://doi.org/10.1186/s13045-021-01180-5Hepatocellular carcinomaHepatectomyTranscatheter arterial chemoembolizationAdjuvant therapySurvival |
| spellingShingle | Lei Liang Chao Li Ming-Da Wang Hong Wang Ya-Hao Zhou Yong-Yi Zeng Wan-Guang Zhang Ting-Hao Chen Nan-Ya Wang Jie Li Yao-Ming Zhang Yu Wang Wei-Min Gu Hao Xing Yong-Kang Diao Wan Yee Lau Cheng-Wu Zhang Timothy M. Pawlik Feng Shen Dong-Sheng Huang Tian Yang Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma Journal of Hematology & Oncology Hepatocellular carcinoma Hepatectomy Transcatheter arterial chemoembolization Adjuvant therapy Survival |
| title | Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma |
| title_full | Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma |
| title_fullStr | Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma |
| title_full_unstemmed | Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma |
| title_short | Development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma |
| title_sort | development and validation of a novel online calculator for estimating survival benefit of adjuvant transcatheter arterial chemoembolization in patients undergoing surgery for hepatocellular carcinoma |
| topic | Hepatocellular carcinoma Hepatectomy Transcatheter arterial chemoembolization Adjuvant therapy Survival |
| url | https://doi.org/10.1186/s13045-021-01180-5 |
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