Ontology highlight
ABSTRACT: Objectives
Models should be developed to assist choice between liver resection (LR) and transarterial chemoembolization (TACE) for hepatocellular carcinoma.Methods
After separating 520 cases from 5 hospitals into training (n = 302) and validation (n = 218) data sets, we weighted the cases to control baseline difference and ensured the causal effect between treatments (LR and TACE) and estimated progression-free survival (PFS) difference. A noninvasive PFS model was constructed with clinical factors, radiological characteristics, and radiomic features. We compared our model with other 4 state-of-the-art models. Finally, patients were classified into subgroups with and without significant PFS difference between treatments.Results
Our model included treatments, age, sex, modified Barcelona Clinic Liver Cancer stage, fusion lesions, hepatocellular carcinoma capsule, and 3 radiomic features, with good discrimination and calibrations (area under the curve for 3-year PFS was 0.80 in the training data set and 0.75 in the validation data set; similar results were achieved in 1- and 2-year PFS). The model had better accuracy than the other 4 models. A nomogram was built, with different scores assigned for LR and TACE. Separated by the threshold of score difference between treatments, for some patients, LR provided longer PFS and might be the better option (training: hazard ratio [HR] = 0.50, P = 0.014; validation: HR = 0.52, P = 0.026); in the others, LR provided similar PFS with TACE (training: HR = 0.84, P = 0.388; validation: HR = 1.14, P = 0.614). TACE may be better because it was less invasive.Discussion
We propose an individualized model predicting PFS difference between LR and TACE to assist in the optimal treatment choice.
SUBMITTER: Fu S
PROVIDER: S-EPMC6736221 | biostudies-literature | 2019 Aug
REPOSITORIES: biostudies-literature
Fu Sirui S Wei Jingwei J Zhang Jie J Dong Di D Song Jiangdian J Li Yong Y Duan Chongyang C Zhang Shuaitong S Li Xiaoqun X Gu Dongsheng D Chen Xudong X Hao Xiaohan X He Xiaofeng X Yan Jianfeng J Liu Zhenyu Z Tian Jie J Lu Ligong L
Clinical and translational gastroenterology 20190801 8
<h4>Objectives</h4>Models should be developed to assist choice between liver resection (LR) and transarterial chemoembolization (TACE) for hepatocellular carcinoma.<h4>Methods</h4>After separating 520 cases from 5 hospitals into training (n = 302) and validation (n = 218) data sets, we weighted the cases to control baseline difference and ensured the causal effect between treatments (LR and TACE) and estimated progression-free survival (PFS) difference. A noninvasive PFS model was constructed wi ...[more]