<p>A Novel Scoring System for Patients with Recurrence of Hepatocellular Carcinoma After Undergoing Minimal Invasive Therapies</p>

Abstract

Background: The higher recurrence rate of hepatocellular carcinoma (HCC) needs to be urgently controlled. However, definitive markers are lacking for patients with recurrence of HCC after undergoing minimal invasive therapies-local ablation combined with transcatheter arterial chemoembolization (TACE). Materials and methods: Demographic and clinicopathological data of 234 subjects receiving combined therapies as the initial treatment were retrospectively analyzed. Univariate and multivariate Cox regression analysis was used to assess independent risk factors of recurrence. Selected variables were divided into low-, intermediate-, and high-risk groups of recurrence according to the scores assigned to them based on their respective hazard ratio (HR) values. The area under the curve (AUC) was used to evaluate the predictive value of the scoring system. Cumulative recurrence-free survival (RFS) and overall survival rates were calculated by the Kaplan-Meier estimator. Finally, a correlation analysis was performed on demographic and clinical data among the three groups. Results: The AUC of predicting 1-, 2-, and 3-year recurrence rates was 0.680, 0.728, and 0.709, respectively. The cumulative RFS rate in the low-risk group at 1, 2, and 3 years after undergoing combined treatments was 4%, 12.2%, and 30.6%, while that in the intermediaterisk group and high-risk group was 23.4%, 51.6%, 60.0%, and 47.3%, 78.2%, 83.6%, respectively. Gamma-glutamyltransferase (γ-GT), blood urea nitrogen (BUN), and total cholesterol (TC) levels among the three groups were statistically different. Conclusion: The scoring system of the present study for patients with the recurrence of HCC after undergoing TACE combined with local ablation may help physicians make a reasonable clinical decision, providing ideal management for diagnosis and treatment.

Interim efficacy and safety of PD-1 inhibitors in preventing recurrence of hepatocellular carcinoma after interventional therapy

“…Another limitation of this study was that the total number of patients analyzed was relatively small, with a comparatively short follow-up period. Our previous studies showed that early recurrence often occurs in the first 2-3 years after ablation, making up about 70% of recurrence events ( 19 ). Moreover, as an interim analysis, our study is not concluded here.…”

“…All patients classified as China liver cancer staging (CNLC) I a, I b, II a, or II b satisfied the criteria of Class A or B of the Child-Pugh classification and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Only high relapse-risk patients were included, which was evaluated by a scoring system ( 19 )established in our previous research.…”

“…Many factors could predict treatment failures, such as tumor size, alpha-fetoprotein (AFP), Child-Pugh score, and BCLC stages ( 15 – 18 ). Our team developed a novel scoring system based on gender, tumor number, AFP, Fib, and albumin-to-prealbumin ratio to stratify patients with HCC into groups with different recurrence risks ( 19 ). At one year after locoregional interventional therapy, the recurrence rate in the low and intermediate-risk groups was 4% and 23.4%, while the high-risk group was 47.3%, with an area under the curve of 0.68.…”

The Dynamic Changes of AFP From Baseline to Recurrence as an Excellent Prognostic Factor of Hepatocellular Carcinoma After Locoregional Therapy: A 5-Year Prospective Cohort Study

“…All patients enrolled received TACE combined with locoregional ablation, and the latter was conducted under computed tomography (CT) or magnetic resonance imaging (MRI) guidance within 2 weeks after TACE. The operational steps of the two interventions have been described in detail in the previous articles of our team, so we won’t go into them here ( 9 ).…”

External validation and improvement of the scoring system for predicting the prognosis in hepatocellular carcinoma after interventional therapy

“…Based on the above background, our team developed a novel scoring system built on account of HCC patients diagnosed between 2015 and 2016 to predict the risk of recurrence after local treatment, and it has achieved a good response in clinical use (13). The patients were stratified into low, intermediate, and high-risk groups of recurrence according to predicted probability, with significant statistical differences in RFS among different subgroups.…”