Screening HCC Patients Who Can Benefit from the Sequential Treatment of Conversion Therapy and Radical Surgery and Constructing a Predictive Model.

BACKGROUND/OBJECTIVE: This study aimed to develop a new nomogram to predict the likelihood of benefit for patients with advanced HCC who can benefit from the sequential treatment of conversion therapy and radical surgery. MATERIALS AND METHODS: A total of 589 patients who met the criteria were included in this study. According to a 7:3 ratio, the development group included 412 patients, while the validation group included 177 patients. The clinical outcome set for this study was whether one could benefit from radical resection after conversion therapy. Independent risk factors for the outcome were screened through univariable and multivariable Logistic regression analysis. We constructed a nomogram using independent risk factors. The areas under the receiver operating characteristic (ROC) curve, calibration curve, and clinical decision curve were used to evaluate the performance of the model. RESULTS: Sex (OR = 2.000; 95% CI: 1.018, 3.931; p = 0.044), AFP (OR = 0.533; 95% CI: 0.313, 0.907; p = 0.020), targeted therapy and immunotherapy (OR = 3.283; 95% CI: 2.029, 5.312; p < 0.001), and postoperative TACE (OR = 6.544; 95% CI: 4.021, 10.649; p < 0.001) were identified as independent risk factors for determining whether there was a benefit. The AUCs of the nomogram for the development set and the validation set were 0.793(95% CI: 0.749-0.836) and 0.770 (95% CI: 0.697-0.844), respectively. The calibration curves and clinical decision curves of the nomogram indicate that it has good predictive performance. CONCLUSIONS: This study developed a nomogram for predicting whether HCC patients can benefit from the sequential treatment of conversion therapy and radical surgery. This is of great help for us to formulate treatment strategies for patients with advanced HCC.