Validation of Pre-/Post-TACE-Predict Models among Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization

Simple Summary Transarterial chemoembolization (TACE) is used to treat patients with intermediate stage hepatocellular carcinoma (HCC). However, models to accurately predict survival are lacking. The aim of our retrospective study was to attempt to validate the prognostic performance of the newly proposed Pre- and Post-TACE-Predict models with Korean patients. In our study of 187 patients with HCC who underwent TACE, there was no significant difference between the Pre- and Post-TACE prediction models in HCC patients. Additionally, simple scoring prognosis prediction models performed similarly to or better than the Pre- and Post-TACE-Predict models in our study. Thus, simple scoring prognosis prediction models such as modified hepatoma arterial embolization prognostic (mHAP)-II and SNACOR may be useful in assessing the TACE treatment survival over the Pre- and Post-TACE-Predict models in patients with HCC. This study attempted to validate the prognostic performance of the proposed Pre- and Post-TACE (transarterial chemoembolization)-Predict models, in comparison with other models for prognostication. One-hundred-and-eighty-seven patients with HCC who underwent TACE were recruited. Regarding overall survival (OS), the predictive performance of the Pre-TACE-Predict model (one-year integrated area under the curve (iAUC) 0.685 (95% confidence interval (CI) 0.593-0.772)) was better than that of the Post-TACE-Predict model (iAUC 0.659 (95% CI 0.580-0.742)). However, there was no significant statistical difference between two models at any time point. For comparison between models using pre-treatment factors, the modified hepatoma arterial embolization prognostic (mHAP)-II model demonstrated significantly better predictive performance at one year (iAUC 0.767 (95% CI 0.683-0.847)) compared with Pre-TACE-Predict. For comparison between models using first TACE response, the SNACOR model was significantly more predictive at one year (iAUC 0.778 (95% CI 0.687-0.866) vs. 0.659 (95% CI 0.580-0.742), respectively) and three years (iAUC 0.707 (95% CI 0.646-0.770) vs. 0.624 (95% CI 0.564-0.688), respectively) than the Post-TACE-Predict model. mHAP-II and SNACOR may be preferred over the Pre- and Post-TACE-Predict models, respectively, considering their similar or better performance and the ease of application.

Automated summary

This study attempted to validate the prognostic performance of the proposed Pre- and Post-TACE (transarterial chemoembolization)-Predict models, in comparison with other models for prognostication. The Pre-TACE-Predict model had better predictive performance than the Post-TACE-Predict model for overall survival, but there was no significant difference between the two models at any time point. The modified hepatoma arterial embolization prognostic (mHAP)-II model showed significantly better predictive performance compared to Pre-TACE-Predict when using pre-treatment factors, and the SNACOR model was significantly more predictive than the Post-TACE-Predict model when using first TACE response.