Recalibrating survival prediction among patients receiving trans‐arterial chemoembolization for hepatocellular carcinoma. Issue 2 (18th July 2021)

• Record Type: Journal Article
• Authors: Cucchetti, Alessandro; Giannini, Edoardo G.; Mosconi, Cristina; Plaz Torres, Maria Corina; Pieri, Giulia; Farinati, Fabio; Rapaccini, Gian Ludovico; Di Marco, Maria; Caturelli, Eugenio; Sacco, Rodolfo; Cabibbo, Giuseppe; Campani, Claudia; Mega, Andrea; Guarino, Maria; Gasbarrini, Antonio; Svegliati‐Baroni, Gianluca; Foschi, Francesco Giuseppe; Missale, Gabriele; Masotto, Alberto; Nardone, Gerardo; Raimondo, Giovanni; Vidili, Gianpaolo; Brunetto, Maurizia Rossana; Sansone, Vito; Zoli, Marco; Azzaroli, Francesco; Trevisani, Franco
• Other Names: Biselli Maurizio investigator.; Caraceni Paolo investigator.; Gramenzi Annagiulia investigator.; Rampoldi Davide investigator.; Reggidori Nicola investigator.; Santi Valentina investigator.; Stefanini Benedetta investigator.; Granito Alessandro investigator.; Muratori Luca investigator.; Piscaglia Fabio investigator.; Tovoli Francesco investigator.; Magalotti Donatella investigator.; Dajti Elton investigator.; Marasco Giovanni investigator.; Ravaioli Federico investigator.; Cappelli Alberta investigator.; Golfieri Rita investigator.; Mosconi Cristina investigator.; Renzulli Matteo investigator.; Pelizzaro Filippo investigator.; Penzo Barbara investigator.; Marina Cela Ester investigator.; Facciorusso Antonio investigator.; Cacciato Valentina investigator.; Casagrande Edoardo investigator.; de Matthaeis Nicoletta investigator.; Allegrini Gloria investigator.; Lauria Valentina investigator.; Ghittoni Giorgia investigator.; Pelecca Giorgio investigator.; Chegai Fabrizio investigator.; Coratella Fabio investigator.; Ortenzi Mariano investigator.; Dell'Isola Serena investigator.; Biasini Elisabetta investigator.; Olivani Andrea investigator.; Inno Alessandro investigator.; Marchetti Fabiana investigator.; Celsa Ciro investigator.; Grova Mauro investigator.; Stornello Caterina investigator.; Busacca Anita investigator.; Cammà Calogero investigator.; Maria Rizzo Giacomo Emanuele investigator.; Franzè Maria Stella investigator.; Saitta Carlo investigator.; Sauchella Assunta investigator.; Napoli Lucia investigator.; Bevilacqua Vittoria investigator.; Berardinelli Dante investigator.; Borghi Alberto investigator.; Gardini Andrea Casadei investigator.; Conti Fabio investigator.; Cucchetti Alessandro investigator.; Dall'Aglio Anna Chiara investigator.; Ercolani Giorgio investigator.; Marra Fabio investigator.; Di Bonaventura Chiara investigator.; Gitto Stefano investigator.; Adotti Valentina investigator.; Coccoli Pietro investigator.; Malerba Antonio investigator.; Capasso Mario investigator.; Morisco Filomena investigator.; Oliveri Filippo investigator.; Romagnoli Veronica investigator.;
• Is Part Of: Liver Cancer International. Volume 2:Issue 2(2021)
• Page Start: 45
• Page End: 53
• Publication Date: 2021-07-18
• Subjects: hepatocellular carcinoma -- prediction model -- recalibration in the large -- survival -- trans‐arterial chemoembolization; Liver -- Cancer -- Periodicals; 616.99436
• DOI: 10.1002/lci2.33
• Languages: English
• ISSNs: 2642-3561

Abstract

Abstract: Background & Aims: The Pre‐TACE‐Predict model was devised to assess prognosis of patients treated with trans‐arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). However, before entering clinical practice, a model should demonstrate that it performs a useful role. Methods: We performed an independent external validation of the Pre‐TACE model in a cohort that differs in setting and time period from the one that generated the original model. Data from 826 patients treated with TACE for naïve HCC (2008‐2018) were used to assess calibration and discrimination of the Pre‐TACE‐Predict model. Results: The four risk‐categories identified by the Pre‐TACE‐Predict model had gradient monotonicity, with median survivals of 52.0, 36.2, 29.9, and 14.1 months respectively. However, predicted survivals systematically underestimated observed survivals ( R 2 : 0.667). A recalibration was adopted maintaining fixed the prognostic index and modifying the baseline survival function. This resulted in an almost perfect calibration ( R 2 : 0.995) in all the four risk categories. Cox regressions showed that aetiology and macrovascular invasion, included in the Pre‐TACE‐Predict model, had no prognostic impact in the present study population, and that coefficients for tumour size and multiplicity were overestimated. The c ‐index was similar to that of the m‐HAP‐III, but higher than those of HAP, m‐HAP‐II and the six‐and‐twelve models. Conclusions: The recalibration of Pre‐TACE‐Predict model improved the estimation of survival probabilities of HCC patients treated with TACE. The highest discriminatory ability of the Pre‐TACE‐model in comparison to other available models, together with risk stratification and recalibration, makes it the best prognostic tool currently available for these patients. Abstract :