A Clinical-Imaging Nomogram for Predicting Early Recurrence in Patients with Solitary Hepatocellular Carcinoma After Postoperative Adjuvant TACE.

OBJECTIVE

This study aimed to identify independent predictors of early recurrence (ER) and to establish a clinically applicable, individualized nomogram for patients with solitary hepatocellular carcinoma (HCC) who underwent postoperative adjuvant transarterial chemoembolization (PA-TACE).

METHODS

A total of 165 patients with solitary HCC treated with PA-TACE between January 2018 and December 2022 were retrospectively analyzed. Among these patients, 71 experienced ER, while 94 remained recurrence-free for over 24 months. Independent prognostic variables were identified through univariate and multivariate Cox regression analyses. These factors were integrated into a nomogram model, and its performance was evaluated using internal validation and calibration curves.

RESULTS

Multivariate analysis revealed that AFP-L3% >10% ( = 0.009), presence of satellite lesions ( = 0.026), GLR >20 ( = 0.020), microvascular invasion (MVI) ( = 0.008), and Ki-67 expression >50% ( < 0.001) were independently associated with ER. These five variables were used to establish the nomogram, which had a C-index of 0.763 (95% CI: 0.736-0.870).

CONCLUSION

A nomogram incorporating AFP-L3, satellite lesions, GLR, MVI, and Ki-67 for predicting ER in patients with solitary HCC following PA-TACE was developed and validated. This model exhibits high predictive accuracy and provides a valuable tool for identifying patients who may benefit from PA-TACE.