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Clinical-Radiomic Analysis for Pretreatment Prediction of Objective Response to First Transarterial Chemoembolization in Hepatocellular Carcinoma.

Authors :
Chen, Mingyu
Cao, Jiasheng
Hu, Jiahao
Topatana, Win
Li, Shijie
Juengpanich, Sarun
Lin, Jian
Tong, Chenhao
Shen, Jiliang
Zhang, Bin
Wu, Jennifer
Pocha, Christine
Kudo, Masatoshi
Amedei, Amedeo
Trevisani, Franco
Sung, Pil Soo
Zaydfudim, Victor M.
Kanda, Tatsuo
Cai, Xiujun
Source :
Liver Cancer (2235-1795); 2021, Vol. 10 Issue 1, p38-51, 14p
Publication Year :
2021

Abstract

Background: The preoperative selection of patients with intermediate-stage hepatocellular carcinoma (HCC) who are likely to have an objective response to first transarterial chemoembolization (TACE) remains challenging. Objective: To develop and validate a clinical-radiomic model (CR model) for preoperatively predicting treatment response to first TACE in patients with intermediate-stage HCC. Methods: A total of 595 patients with intermediate-stage HCC were included in this retrospective study. A tumoral and peritumoral (10 mm) radiomic signature (TPR-signature) was constructed based on 3,404 radiomic features from 4 regions of interest. A predictive CR model based on TPR-signature and clinical factors was developed using multivariate logistic regression. Calibration curves and area under the receiver operating characteristic curves (AUCs) were used to evaluate the model's performance. Results: The final CR model consisted of 5 independent predictors, including TPR-signature (p < 0.001), AFP (p = 0.004), Barcelona Clinic Liver Cancer System Stage B (BCLC B) subclassification (p = 0.01), tumor location (p = 0.039), and arterial hyperenhancement (p = 0.050). The internal and external validation results demonstrated the high-performance level of this model, with internal and external AUCs of 0.94 and 0.90, respectively. In addition, the predicted objective response via the CR model was associated with improved survival in the external validation cohort (hazard ratio: 2.43; 95% confidence interval: 1.60–3.69; p < 0.001). The predicted treatment response also allowed for significant discrimination between the Kaplan-Meier curves of each BCLC B subclassification. Conclusions: The CR model had an excellent performance in predicting the first TACE response in patients with intermediate-stage HCC and could provide a robust predictive tool to assist with the selection of patients for TACE. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
22351795
Volume :
10
Issue :
1
Database :
Complementary Index
Journal :
Liver Cancer (2235-1795)
Publication Type :
Academic Journal
Accession number :
148769969
Full Text :
https://doi.org/10.1159/000512028