Background/Objectives: The Barcelona Clinic Liver Cancer (BCLC) staging system for hepatocellular carcinoma (HCC) was updated in 2022 to refine patient stratification, particularly in patients with intermediate-stage (BCLC B) HCC. Although transarterial chemoembolization (TACE) remains a key treatment for these patients, there is no prognostic model for survival outcomes based on the pretreatment factors of patients who meet the updated 2022 BCLC indications for TACE. The aim of this study was to develop a pretreatment risk model predicting overall survival (OS) in patients with intermediate-stage HCC and reclassified as candidates for TACE according to the updated 2022 BCLC criteria.Methods: This retrospective study included 658 HCC patients treated with first-line TACE according to the updated BCLC 2022 guidelines. Pretreatment factors such as the Child–Pugh score, tumor burden (up-to-11 criteria), bilobar tumor involvement, and serum alpha-fetoprotein (AFP) levels were analyzed. Cox proportional hazards models were used to identify significant predictors of OS, with these factors subsequently incorporated into a risk prediction model.Results: Significant predictors of OS included Child–Pugh score ≥ 7, bilobar tumor involvement, beyond up-to-11 criteria, and AFP ≥ 400 ng/mL. A risk model was developed using these factors, stratifying patients into low-, intermediate-, and high-risk groups. The median OS in the low-, intermediate-, and high-risk groups was 53, 35, and 21 months, respectively.Conclusions: The proposed pretreatment risk prediction model may be useful for predicting OS and guiding TACE candidacy in intermediate-stage HCC patients based on the updated 2022 BCLC guidelines.
背景/目的：巴塞罗那临床肝癌（BCLC）分期系统于2022年更新，旨在优化肝细胞癌（HCC）患者分层，特别是针对中期（BCLC B期）患者。虽然经动脉化疗栓塞（TACE）仍是此类患者的关键治疗手段，但目前尚无基于符合2022年更新版BCLC TACE适应症患者治疗前因素的生存预后模型。本研究旨在建立一个治疗前风险模型，用于预测根据2022年更新版BCLC标准重新归类为TACE候选者的中期HCC患者的总生存期（OS）。 方法：这项回顾性研究纳入了658例根据更新版BCLC 2022指南接受一线TACE治疗的HCC患者。分析了治疗前因素，包括Child-Pugh评分、肿瘤负荷（up-to-11标准）、双叶肿瘤累及以及血清甲胎蛋白（AFP）水平。采用Cox比例风险模型确定OS的显著预测因子，并将这些因素纳入风险预测模型。 结果：OS的显著预测因子包括Child-Pugh评分≥7分、双叶肿瘤累及、超出up-to-11标准以及AFP≥400 ng/mL。基于这些因素构建的风险模型将患者分为低、中、高风险组。低、中、高风险组的中位OS分别为53、35和21个月。 结论：基于2022年更新版BCLC指南，所提出的治疗前风险预测模型可能有助于预测中期HCC患者的OS并指导其TACE治疗候选资格的评估。
肿瘤(癌症)患者之家