Bin-Yan Zhong1, Zhi-Ping Yan2,3,4, Jun-Hui Sun5, Lei Zhang1, Zhong-Heng Hou1, Min-Jie Yang2,3,4, Guan-Hui Zhou5, Wan-Sheng Wang1, Zhi Li1, Peng Huang1, Shen Zhang1, Xiao-Li Zhu1, Cai-Fang Ni1. 1. Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China. 2. Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China. 3. Shanghai Institution of Medical Imaging, Shanghai, China. 4. National Clinical Research Center for Interventional Medicine, Shanghai, China. 5. Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Abstract
PURPOSE: To establish albumin-bilirubin (ALBI) grade-based and Child-Turcotte-Pugh (CTP) grade-based nomograms, as well as to develop an artificial neural network (ANN) model to compare the prognostic performance and discrimination of these two grades for hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) combined with sorafenib as an initial treatment. METHODS: This multicenter retrospective study included patients from three hospitals between January 2013 and August 2018. In the training cohort, independent risk factors associated with overall survival (OS) were identified by univariate and multivariate analyses. The nomograms and ANN were established and then validated in two validation cohorts. RESULTS: A total of 504 patients (319, 61, and 124 patients from hospitals A, B, and C, respectively) were included. The median OS was 15.2, 26.9, and 14.8 months in the training cohort and validation cohorts 1 and 2, respectively (P = 0.218). In the training cohort, both ALBI grade and CTP grade were identified as independent risk factors. The ALBI grade-based and CTP grade-based nomograms were established separately and showed similar prognostic performance and discrimination when validated in the validation cohorts (C-index in validation cohort 1: 0.799 vs. 0.779, P = 0.762; in validation cohort 2: 0.700 vs. 0.693, P = 0.803). The ANN model showed that the ALBI grade had higher importance in survival prediction than the CTP grade. CONCLUSIONS: The ALBI grade and CTP grade have comparable prognostic performance for HCC patients treated with TACE combined with sorafenib. ALBI grades 1 and 2 have the potential to act as a stratification factor for clinical trials on the combination therapy of TACE and systemic therapy.
PURPOSE: To establish albumin-bilirubin (ALBI) grade-based and Child-Turcotte-Pugh (CTP) grade-based nomograms, as well as to develop an artificial neural network (ANN) model to compare the prognostic performance and discrimination of these two grades for hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) combined with sorafenib as an initial treatment. METHODS: This multicenter retrospective study included patients from three hospitals between January 2013 and August 2018. In the training cohort, independent risk factors associated with overall survival (OS) were identified by univariate and multivariate analyses. The nomograms and ANN were established and then validated in two validation cohorts. RESULTS: A total of 504 patients (319, 61, and 124 patients from hospitals A, B, and C, respectively) were included. The median OS was 15.2, 26.9, and 14.8 months in the training cohort and validation cohorts 1 and 2, respectively (P = 0.218). In the training cohort, both ALBI grade and CTP grade were identified as independent risk factors. The ALBI grade-based and CTP grade-based nomograms were established separately and showed similar prognostic performance and discrimination when validated in the validation cohorts (C-index in validation cohort 1: 0.799 vs. 0.779, P = 0.762; in validation cohort 2: 0.700 vs. 0.693, P = 0.803). The ANN model showed that the ALBI grade had higher importance in survival prediction than the CTP grade. CONCLUSIONS: The ALBI grade and CTP grade have comparable prognostic performance for HCC patients treated with TACE combined with sorafenib. ALBI grades 1 and 2 have the potential to act as a stratification factor for clinical trials on the combination therapy of TACE and systemic therapy.
Authors: Jan Hansmann; Maximilian J Evers; James T Bui; R Peter Lokken; Andrew J Lipnik; Ron C Gaba; Charles E Ray Journal: J Vasc Interv Radiol Date: 2017-07-06 Impact factor: 3.464
Authors: I G Rapposelli; S Shimose; T Kumada; S Okamura; A Hiraoka; G G Di Costanzo; F Marra; E Tamburini; A Forgione; F G Foschi; M Silletta; S Lonardi; G Masi; M Scartozzi; M Nakano; H Shibata; K Kawata; A Pellino; C Vivaldi; E Lai; A Takata; K Tajiri; H Toyoda; R Tortora; C Campani; M G Viola; F Piscaglia; F Conti; C A M Fulgenzi; G L Frassineti; M D Rizzato; F Salani; G Astara; T Torimura; M Atsukawa; T Tada; V Burgio; M Rimini; S Cascinu; A Casadei-Gardini Journal: ESMO Open Date: 2021-06-15