Surveillance Strategy for Barcelona Clinic Liver Cancer B Hepatocellular Carcinoma Achieving Complete Response: An Individualized Risk-Based Machine Learning Study

Abstract

Background: For patients with complete response (CR) of Barcelona Clinical Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC), there is no consensus regarding the monitoring strategy. Optimal surveillance strategies that can detect early progression of HCC within a limited visit after treatment have not yet been investigated. A retrospective, real-world study was conducted to investigate surveillance strategies for BCLC stage B HCC (BBHCC) patients with CR after curative treatment to support clinical decision making.Methods: From January 2007 to December 2019, 546 BBHCC patients with CR after radical treatment were collected at Sun Yat-sen University Cancer Center. Seventy percent of patients were subjected to the train cohort randomly; the remaining patients comprised the validation cohort to verify the proposed arrangements. The random survival forest method was applied to calculate the disease progression hazard per month, and follow-up schedules were arranged to maximize the capability of progression detection at each visit. The primary endpoint of the study was the delayed-detection months for disease progression.Results: The cumulative 1, 2, and 3-years risk-adjusted probabilities for the train/validation cohorts were 32.8%/33.7%, 54.0%/56.3%, and 64.0%/67.4%, respectively, with peaks around approximately the 9th month. The surveillance regime was primarily concentrated in the first year posttreatment. The delayed-detection months gradually decreased when the total follow-up times increased from 6 to 11. Compared with controls, our schedule reduced delayed detection. Typically, the benefits of our surveillance regimes were obvious when the patients were followed seven times according to our schedule. The optional schedules were 5, 7, 9, 11, 17, 23, and 30 months.Conclusion: The proposed new surveillance schedule may provide a new perspective concerning follow-up for BBHCC patients with CR.

Assessing the Prognostic Capability of Immune-Related Gene Scoring Systems in Lung Adenocarcinoma

“…Prognostic immunity-related genes were obtained by univariate Cox regression screening on survival status for each gene in the training set. Genes that showed significant differences ( P < 0.01) in the Cox regression were subsequently analyzed using the stochastic survival forest algorithm (RSFA) for dimensionality reduction [ 14 ]. In addition, the equation is shown below: …”

Bibliometric Analysis of the Literature Concerning Anesthesia in Liver Tumor Ablation Published in the Web of Science Core Collection (WoSCC) Database from 1999 to 2022

“…Liver tumor ranks the fourth and third places among cancers worldwide in terms of its morbidity and mortality, respectively [ 1 ]. Currently, major curative treatments are surgical liver transplantation, resection, and ablation [ 2 ]; however, many patients have distant metastasis, lymphatic metastasis, and cirrhosis at the time of diagnosis. Consequently, 70% of such patients cannot receive radical surgical treatment.…”