Risk network calculators and prognosticators for Embolic syndrome after TACE in hepatocellular carcinoma

Abstract

Abstract: Objective: To analyse the prognostic impact of post-embolisation syndrome (PES) after first transarterial chemoembolisation (TACE) for advanced hepatocellular carcinoma (HCC), and to analyse the risk factors for PES and construct a risk assessment network calculator.
Methods: Patients with advanced HCC treated with first TACE between January 2020 and September 2022 in our hospital were selected. Kaplan-Meier method were used to survival analysis, and unifactorial and multifactorial Cox risk regression were used to analyse patients' risk factors for death. Multifactorial logistic regression model was used to analyse PES risk factors, column line graphs of advanced PES risk were constructed based on PES risk factors, internal dataset was used for calibration curves, decision curves, and clinical impact curves analysis, and column line graphs were published into Netwatch to construct the Risk Assessment Network Calculator.
Results: The incidence of PES after the first TACE was 62.6% in 147 patients with advanced HCC.The mean follow-up time after TACE was (12.42 ± 3.58) months, of which 99 (67.3%) patients died.The overall survival rate of patients with PES was lower than that of patients with non-PES (P<0.05). Multifactorial Cox proportional risk regression showed that PES, number of TACE and combination therapy were independent risk factors for prognosis in patients with advanced HCC (all P<0.05). Multifactorial logistic regression analysis showed that age, maximum tumour diameter, drug delivery route, total bilirubin (TB) and albumin (ALB) were independent risk factors for PES (all P<0.05). The area under the curve of the receiver operating characteristic curve - curve of the predicted PES risk nomogram was 0.863 (0.796-0.914), and the calibration curve showed a C-index of 0.879, which indicated that the nomogram had a high predictive accuracy.
Conclusions: PES is associated with reduced survival in patients with advanced HCC after TACE. A PES risk network calculator based on age, maximum tumour diameter, drug delivery method, TB and ALB can provide a reference basis for more active measures to manage PES.

Key words: Advanced, Hepatocellular carcinoma, Transarterial chemoembolisation, Embolisation syndrome, Network calculator, Prognosis

Chen Yan, Tian Qifeng, Chen Cheng, Tian Shuilin. Risk network calculators and prognosticators for Embolic syndrome after TACE in hepatocellular carcinoma[J]. Electronic Journal of Liver Tumor, 2025, 12(1): 33-38.

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