title: Postsurgical treatment with adjuvant transarterial chemoembolization in patients with hepatitis B-related hepatocellular carcinoma: A strobe-compliant article.
abstract: This study sought to develop a reliable and easy-to-use scoring model to guide the decision to perform postsurgical adjuvant transarterial chemoembolization (PA-TACE) in patients with hepatitis B-related hepatocellular carcinoma (HCC).The study included 235 consecutive patients with hepatitis B-related HCC undergoing PA-TACE at our medical center. Patients were assigned to 2 sets according to the PA-TACE date: initial (2005-2007; n = 130) and internal validation (2008-2009; n = 105) sets. With the aid of a Cox regression model, we developed a risk-scoring model from the independent predictive factors of our initial set designed as a guide for PA-TACE, and the performance of the model was validated with an internal set. External validation was also performed with an independent dataset (n = 84) to assess the discriminatory power of the scoring model.In the multivariate analysis, 4 risk factors (an increase in Child-Pugh score of at least 1 point, hepatitis B virus deoxyribonucleic acid [HBV-DNA] level >10 IU/mL, tumor diameter ≥5 cm, and the presence of vascular invasion) were significantly associated with prognosis. These factors were incorporated into a novel clinicopathological scoring model (assessment for PA-TACE [APT] risk-scoring model) ranging from 0 to 8 that was correlated with prognosis. Different survival outcomes were identified in three groups (0-2 points, 3-6 points, and 7-8 points). The risk-scoring model was further confirmed with 2 independent sets.The novel APT risk-scoring model, merging 4 prognostic factors, may achieve an optimal postsurgical prediction of PA-TACE in HBV-related HCC. The risk for an individual patient with an APT score of ≥7.0 prior to the PA-TACE, who may not profit from further PA-TACE, can be determined, and this may lead to a more appropriate choice of treatment.
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Liver Cancer Institute, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Hu
authors.forename: Rong
authors.initials: R
authors.lastname: Liu
authors.forename: Xiao Ran
authors.initials: XR
authors.lastname: Long
authors.forename: Xi Kun
authors.initials: XK
authors.lastname: Han
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.forename: Zhi Ping
authors.initials: ZP
authors.lastname: Yan
authors.forename: Jian Hua
authors.initials: JH
authors.lastname: Wang
mesh_terms: D000328:Adult; D001808:Blood Vessels / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy* / Q000821:virology; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006498:Hepatectomy; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D015996:Survival Rate; D047368:Tumor Burden
chemical_list: D004279:DNA, Viral