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Combinatorial Chemistry & High Throughput Screening

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ISSN (Print): 1386-2073
ISSN (Online): 1875-5402

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Research Article

Development and Validation of a Risk Prediction Algorithm for Evaluating the Efficacy of Postoperative Adjuvant TACE Therapy for Hepatocellular Carcinoma

Author(s): Jie Tao, Xiaoli Shi, Xu Feng, Xinhua Wu, Shiguai Qi, Guoying Feng, Xu Yang, Yufei Zhao, Hangjia Zuo and Zhengrong Shi*

Volume 27, Issue 8, 2024

Published on: 24 August, 2023

Page: [1111 - 1118] Pages: 8

DOI: 10.2174/1386207326666230824090204

Price: $65

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Abstract

Background and Purpose: There is a lack of a reliable outcome prediction model for patients evaluating the feasibility of postoperative adjuvant transarterial chemoembolization (PATACE) therapy. Our goal was to develop an easy-to-use tool specifically for these patients.

Methods: From January 2013 to June 2017, patients with hepatocellular carcinoma from the Liver Center of the First Affiliated Hospital of Chongqing Medical University received postoperative adjuvant Transarterial chemoembolization (TACE) therapy after liver cancer resection. A Cox proportional hazards model was established for these patients, followed by internal validation (enhanced bootstrap resampling technique) to further evaluate the predictive performance and discriminanceevaluate the predictive performance and discriminance, and compare it with other predictive models. The prognostic factors considered included tumour number, maximum tumor diameter, Edmondson-Steiner (ES) grade, Microvascular invasion (MVI) grade, Ki67, age, sex, hepatitis B surface antigen, cirrhosis, Alpha-fetoprotein (AFP), Albumin-bilirubin (ALBI) grade, Childpugh grade, body mass index (BMI), Neutrophil-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR).

Results: The endpoint of the study was overall survival. The median overall survival was 36 (95%CI: 34.0-38.0) months, with 1-year, 2-year and 3-year survival rates being 96.3%, 84.0% and 75.3%, respectively. Tumour number, MVI grade, and BMI was incorporated into the model, which had good differentiation and accuracy. Internal validation (enhanced bootstrap) suggested that Harrell’s C statistic is 0.72. The model consistently outperforms other currently available models.

Conclusion: This model may be an easy-to-use tool for screening patients suitable for PA-TACE treatment and guiding the selection of clinical protocols. But further research and external validation are required.

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[1]
Angeli, P.; Bernardi, M.; Villanueva, C.; Francoz, C.; Mookerjee, R.P.; Trebicka, J.; Krag, A.; Laleman, W.; Gines, P. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J. Hepatol., 2018, 69(2), 406-460.
[http://dx.doi.org/10.1016/j.jhep.2018.03.024] [PMID: 29653741]
[2]
Galle, P.R.; Forner, A.; Llovet, J.M.; Mazzaferro, V.; Piscaglia, F.; Raoul, J-L.; Schirmacher, P.; Vilgrain, V. Management of hepatocellular carcinoma. J. Hepatol., 2018, 69(1), 182-236.
[http://dx.doi.org/10.1016/j.jhep.2018.03.019] [PMID: 29628281]
[3]
European Association For The Study Of The Liver. EASL-EORTC clinical practice guidelines: Management of hepatocellular carcinoma. J. Hepatol., 2012, 56(4), 908-943.
[http://dx.doi.org/10.1016/j.jhep.2011.12.001] [PMID: 22424438]
[4]
Ader, I.; Brizuela, L.; Bouquerel, P.; Malavaud, B.; Cuvillier, O. Sphingosine kinase 1: A new modulator of hypoxia inducible factor 1alpha during hypoxia in human cancer cells. Cancer Res., 2008, 68(20), 8635-8642.
[http://dx.doi.org/10.1158/0008-5472.CAN-08-0917] [PMID: 18922940]
[5]
Charette, N.; Vandeputte, C.; Ameye, L.; Bogaert, C.V.; Krygier, J.; Guiot, T.; Deleporte, A.; Delaunoit, T.; Geboes, K.; Van Laethem, J.L.; Peeters, M.; Demolin, G.; Holbrechts, S.; Flamen, P.; Paesmans, M.; Hendlisz, A. Prognostic value of adipose tissue and muscle mass in advanced colorectal cancer: A post hoc analysis of two non-randomized phase II trials. BMC Cancer, 2019, 19(1), 134.
[http://dx.doi.org/10.1186/s12885-019-5319-8] [PMID: 30744591]
[6]
Chen, L.; Ke, Z.; Xiong, F.; Kan, X.; Ren, Y.; Cao, Y.; Sun, T.; Yan, L.; Zhou, G.; Zheng, C. Platelet-to-lymphocyte ratio predicts therapy outcomes of transarterial chemoembolization plus apatinib in the treatment of advanced hepatocellular carcinoma. Anticancer Drugs, 2020, 31(9), 966-972.
[http://dx.doi.org/10.1097/CAD.0000000000000913] [PMID: 31977568]
[7]
Chen, M.Y.; Juengpanich, S.; Hu, J.H.; Topatana, W.; Cao, J.S.; Tong, C.H.; Lin, J.; Cai, X.J. Prognostic factors and predictors of postoperative adjuvant transcatheter arterial chemoembolization benefit in patients with resected hepatocellular carcinoma. World J. Gastroenterol., 2020, 26(10), 1042-1055.
[http://dx.doi.org/10.3748/wjg.v26.i10.1042] [PMID: 32205995]
[8]
Choi, J.; Jo, C.; Lim, Y.S. Tenofovir versus entecavir on recurrence of hepatitis B virus–related hepatocellular carcinoma after surgical resection. Hepatology, 2021, 73(2), 661-673.
[http://dx.doi.org/10.1002/hep.31289] [PMID: 32324905]
[9]
Couri, T.; Pillai, A. Goals and targets for personalized therapy for HCC. Hepatol. Int., 2019, 13(2), 125-137.
[http://dx.doi.org/10.1007/s12072-018-9919-1] [PMID: 30600478]
[10]
Dong, Z.R.; Zhang, P.F.; Wang, C.H.; Zhang, C.; Cai, J.B.; Shi, G.M.; Ke, A.W.; Sun, H.C.; Qiu, S.J.; Zhou, J.; Fan, J. Postoperative adjuvant transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond the Milan criteria: A retrospective analysis. Am. J. Cancer Res., 2014, 5(1), 450-457.
[PMID: 25628953]
[11]
Erstad, D.J.; Tanabe, K.K. Prognostic and therapeutic implications of microvascular invasion in hepatocellular carcinoma. Ann. Surg. Oncol., 2019, 26(5), 1474-1493.
[http://dx.doi.org/10.1245/s10434-019-07227-9] [PMID: 30788629]
[12]
Fan, S.T. Hepatocellular carcinoma—resection or transplant? Nat. Rev. Gastroenterol. Hepatol., 2012, 9(12), 732-737.
[http://dx.doi.org/10.1038/nrgastro.2012.158] [PMID: 22965432]
[13]
Feng, A.L.; Zhu, J.K.; Yang, Y.; Wang, Y.D.; Liu, F.Y.; Zhu, M.; Liu, C.Z. Repeated postoperative adjuvant TACE after curative hepatectomy improves outcomes of patients with HCC. Minim. Invasive Ther. Allied Technol., 2021, 30(3), 163-168.
[http://dx.doi.org/10.1080/13645706.2019.1707689] [PMID: 31880482]
[14]
Harrell, F., Jr; Lee, K.L.; Mark, D.B. Multivariable prognostic models: Issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat. Med., 1996, 15(4), 361-387.
[http://dx.doi.org/10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4] [PMID: 8668867]
[15]
Hong, Y.M.; Cho, M.; Yoon, K.T.; Ryu, J.H.; Yang, K.H.; Jeon, U.B.; Hwang, T.H. Neutrophil-lymphocyte ratio predicts the therapeutic benefit of neoadjuvant transarterial chemoembolization in patients with resectable hepatocellular carcinoma. Eur. J. Gastroenterol. Hepatol., 2020, 32(9), 1186-1191.
[http://dx.doi.org/10.1097/MEG.0000000000001629] [PMID: 31851089]
[16]
Tao, J.; Shi, X.; Feng, X. Development and validation of a risk prediction algorithm for evaluating the efficacy of postoperative adjuvant TACE therapy for hepatocellular carcinoma: A retrospective study; Res. Square, 2022.
[http://dx.doi.org/10.21203/rs.3.rs-1641318/v1]
[17]
Lee, S.; Kang, T.W.; Song, K.D.; Lee, M.W.; Rhim, H.; Lim, H.K.; Kim, S.Y.; Sinn, D.H.; Kim, J.M.; Kim, K.; Ha, S.Y. Effect of microvascular invasion risk on early recurrence of hepatocellular carcinoma after surgery and radiofrequency ablation. Ann. Surg., 2021, 273(3), 564-571.
[http://dx.doi.org/10.1097/SLA.0000000000003268] [PMID: 31058694]
[18]
Li, Q.; Zhang, L.; Hou, Z.H.; Zhao, D.X.; Li, J.B.; Zhang, S.; Yin, Y.; Ni, C.F.; Chen, T. High visceral adipose tissue density correlates with unfavorable outcomes in patients with intermediate-stage hepatocellular carcinoma undergoing transarterial chemoembolization. Front. Cell Dev. Biol., 2021, 9, 710104.
[http://dx.doi.org/10.3389/fcell.2021.710104] [PMID: 34568324]
[19]
Liang, L.; Li, C.; Diao, Y.K.; Jia, H.D.; Xing, H.; Pawlik, T.M.; Lau, W.Y.; Shen, F.; Huang, D.S.; Zhang, C.W.; Yang, T. Survival benefits from adjuvant transcatheter arterial chemoembolization in patients undergoing liver resection for hepatocellular carcinoma: A systematic review and meta-analysis. Therap. Adv. Gastroenterol., 2020, 13.
[http://dx.doi.org/10.1177/1756284820977693] [PMID: 33329759]
[20]
Marasco, G.; Colecchia, A.; Colli, A.; Ravaioli, F.; Casazza, G.; Bacchi Reggiani, M.L.; Cucchetti, A.; Cescon, M.; Festi, D. Role of liver and spleen stiffness in predicting the recurrence of hepatocellular carcinoma after resection. J. Hepatol., 2019, 70(3), 440-448.
[http://dx.doi.org/10.1016/j.jhep.2018.10.022] [PMID: 30389551]
[21]
Moons, K.G.M.; Altman, D.G.; Reitsma, J.B.; Ioannidis, J.P.A.; Macaskill, P.; Steyerberg, E.W.; Vickers, A.J.; Ransohoff, D.F.; Collins, G.S. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): Explanation and elaboration. Ann. Intern. Med., 2015, 162(1), W1-W73.
[http://dx.doi.org/10.7326/M14-0698] [PMID: 25560730]
[22]
Pinato, D.J.; Sharma, R.; Allara, E.; Yen, C.; Arizumi, T.; Kubota, K.; Bettinger, D.; Jang, J.W.; Smirne, C.; Kim, Y.W.; Kudo, M.; Howell, J.; Ramaswami, R.; Burlone, M.E.; Guerra, V.; Thimme, R.; Ishizuka, M.; Stebbing, J.; Pirisi, M.; Carr, B.I. The ALBI grade provides objective hepatic reserve estimation across each BCLC stage of hepatocellular carcinoma. J. Hepatol., 2017, 66(2), 338-346.
[http://dx.doi.org/10.1016/j.jhep.2016.09.008] [PMID: 27677714]
[23]
Sung, H.; Ferlay, J.; Siegel, R.L.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin., 2021, 71(3), 209-249.
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[24]
Vogel, A.; Cervantes, A.; Chau, I.; Daniele, B.; Llovet, J.M.; Meyer, T.; Nault, J.C.; Neumann, U.; Ricke, J.; Sangro, B.; Schirmacher, P.; Verslype, C.; Zech, C.J.; Arnold, D.; Martinelli, E. Hepatocellular carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol., 2018, 29(S4), iv238-iv255.
[http://dx.doi.org/10.1093/annonc/mdy308] [PMID: 30285213]
[25]
Wang, Q.; Xia, D.; Bai, W.; Wang, E.; Sun, J.; Huang, M.; Mu, W.; Yin, G.; Li, H.; Zhao, H.; Li, J.; Zhang, C.; Zhu, X.; Wu, J.; Li, J.; Gong, W.; Li, Z.; Lin, Z.; Pan, X.; Shi, H.; Shao, G.; Liu, J.; Yang, S.; Zheng, Y.; Xu, J.; Song, J.; Wang, W.; Wang, Z.; Zhang, Y.; Ding, R.; Zhang, H.; Yu, H.; Zheng, L.; Gu, W.; You, N.; Wang, G.; Zhang, S.; Feng, L.; Liu, L.; Zhang, P.; Li, X.; Chen, J.; Xu, T.; Zhou, W.; Zeng, H.; Zhang, Y.; Huang, W.; Jiang, W.; Zhang, W.; Shao, W.; Li, L.; Niu, J.; Yuan, J.; Li, X.; Lv, Y.; Li, K.; Yin, Z.; Xia, J.; Fan, D.; Han, G. Development of a prognostic score for recommended TACE candidates with hepatocellular carcinoma: A multicentre observational study. J. Hepatol., 2019, 70(5), 893-903.
[http://dx.doi.org/10.1016/j.jhep.2019.01.013] [PMID: 30660709]
[26]
Wang, Z.; Ren, Z.; Chen, Y.; Hu, J.; Yang, G.; Yu, L.; Yang, X.; Huang, A.; Zhang, X.; Zhou, S.; Sun, H.; Wang, Y.; Ge, N.; Xu, X.; Tang, Z.; Lau, W.; Fan, J.; Wang, J.; Zhou, J. Adjuvant transarterial chemoembolization for hbv-related hepatocellular carcinoma after resection: A randomized controlled study. Clin. Cancer Res., 2018, 24(9), 2074-2081.
[http://dx.doi.org/10.1158/1078-0432.CCR-17-2899] [PMID: 29420221]
[27]
Yang, J.; Liang, H.; Hu, K.; Xiong, Z.; Cao, M.; Zhong, Z.; Yao, Z.; Deng, M. The effects of several postoperative adjuvant therapies for hepatocellular carcinoma patients with microvascular invasion after curative resection: A systematic review and meta-analysis. Cancer Cell Int., 2021, 21(1), 92.
[http://dx.doi.org/10.1186/s12935-021-01790-6] [PMID: 33549093]
[28]
Ye, J.Z.; Chen, J.Z.; Li, Z.H.; Bai, T.; Chen, J.; Zhu, S.L.; Li, L.Q.; Wu, F.X. Efficacy of postoperative adjuvant transcatheter arterial chemoembolization in hepatocellular carcinoma patients with microvascular invasion. World J. Gastroenterol., 2017, 23(41), 7415-7424.
[http://dx.doi.org/10.3748/wjg.v23.i41.7415] [PMID: 29151695]
[29]
Zhang, X.; Li, J.; Shen, F.; Lau, W.Y. Significance of presence of microvascular invasion in specimens obtained after surgical treatment of hepatocellular carcinoma. J. Gastroenterol. Hepatol., 2018, 33(2), 347-354.
[http://dx.doi.org/10.1111/jgh.13843] [PMID: 28589639]
[30]
Zhang, Z.; Liu, Q.; He, J.; Yang, J.; Yang, G.; Wu, M. The effect of preoperative transcatheter hepatic arterial chemoembolization on disease-free survival after hepatectomy for hepatocellular carcinoma. Cancer, 2000, 89(12), 2606-2612.
[http://dx.doi.org/10.1002/1097-0142(20001215)89:12<2606::AID-CNCR13>3.0.CO;2-T] [PMID: 11135222]
[31]
Zhao, Y.F.; Xiong, X.; Chen, K.; Tang, W.; Yang, X.; Shi, Z.R. Evaluation of the therapeutic effect of adjuvant transcatheter arterial chemoembolization based on Ki67 after hepatocellular carcinoma surgery. Front. Oncol., 2021, 11, 605234.
[http://dx.doi.org/10.3389/fonc.2021.605234] [PMID: 33718156]
[32]
Zhou, L.; Rui, J.A.; Ye, D.X.; Wang, S.B.; Chen, S.G.; Qu, Q. Edmondson-Steiner grading increases the predictive efficiency of TNM staging for long-term survival of patients with hepatocellular carcinoma after curative resection. World J. Surg., 2008, 32(8), 1748-1756.
[http://dx.doi.org/10.1007/s00268-008-9615-8] [PMID: 18493820]

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