Background:Early detection of patients at high risk for recurrence or local tumor progression (LTP) following thermal ablation of hepatocellular carcinoma (HCC) is essential for treatment selection and individualized follow-up. This systematic review aims to assess and compare the performance of prognostic models predicting recurrence or LTP in patients with HCC treated with thermal ablation.Methods:PubMed, Web of Science, Cochrane, and Embase were searched for studies developing models to predict recurrence after thermal ablation in treatment-naïve HCC patients, using imaging and clinical data with reported test set performance. Risk of bias and applicability were assessed by the Prediction model Risk of Bias Assessment Tool. Data on model performance, feature extraction and modeling technique was collected.Results:In total, 16 studies comprising 39 prognostic models were included, all developed using retrospective data from China or Korea. Outcomes included recurrence-free survival, (intrahepatic) early recurrence, LTP, late recurrence and aggressive intrasegmental recurrence. Predictive parameters varied across models addressing identical outcomes. Outcome definitions also differed. Nine models were externally validated. Most studies had a high risk of bias due to methodological limitations.Conclusions:Variability in model development methodology and type of predictors was found. Models that integrated multiple types of predictors consistently outperformed those relying on one type. To advance predictive tools toward clinical implementation, future research should prioritize standardized outcome definitions, external testing, and transparent reporting. Until these challenges are addressed, current evaluated models should be regarded as promising but preliminary tools.
背景：早期识别肝细胞癌（HCC）热消融治疗后具有高复发或局部肿瘤进展（LTP）风险的患者，对于治疗方案选择和个体化随访至关重要。本系统综述旨在评估和比较预测HCC热消融治疗后复发或LTP的预后模型的性能。 方法：系统检索PubMed、Web of Science、Cochrane和Embase数据库，纳入基于影像和临床数据、报告测试集性能、旨在预测初治HCC患者热消融后复发的研究模型。使用预测模型偏倚风险评估工具评估偏倚风险和适用性。收集模型性能、特征提取和建模技术相关数据。 结果：共纳入16项研究，涵盖39个预后模型，所有模型均基于中国或韩国的回顾性数据开发。预测结局包括无复发生存期、（肝内）早期复发、LTP、晚期复发和侵袭性肝段内复发。针对相同结局的模型，其预测参数存在差异，结局定义亦不相同。其中9个模型进行了外部验证。多数研究因方法学局限存在高偏倚风险。 结论：研究发现模型开发方法和预测因子类型存在较大异质性。整合多种类型预测因子的模型性能普遍优于依赖单一类型预测因子的模型。为推动预测工具向临床应用转化，未来研究应优先关注结局定义的标准化、外部验证测试以及报告透明化。在解决这些挑战之前，当前评估的模型应被视为有前景但尚属初步的工具。
肿瘤(癌症)患者之家