Yu JH, Yu J, Yu JX, Yang LF, Yan D, Liu Y, Xian JR, Yi PS. Personalized prognosis in unresectable hepatocellular carcinoma: Development and validation of a model for transcatheter arterial chemoembolization plus lenvatinib. World J Gastrointest Oncol 2025; 17(11): 111814 [DOI: 10.4251/wjgo.v17.i11.111814]
Corresponding Author of This Article
Peng-Sheng Yi, PhD, Department of Hepato-Pancreato-Biliary II, National Clinical Key Specialty, Sub-center of National Clinical Research Center for Digestive Diseases, Sichuan Clinical Research Center for Digestive Diseases, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong 637000, Sichuan Province, China. 13065256256@163.com
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Oncology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 13, 2025
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World Journal of Gastrointestinal Oncology
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1948-5204
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Yu JH, Yu J, Yu JX, Yang LF, Yan D, Liu Y, Xian JR, Yi PS. Personalized prognosis in unresectable hepatocellular carcinoma: Development and validation of a model for transcatheter arterial chemoembolization plus lenvatinib. World J Gastrointest Oncol 2025; 17(11): 111814 [DOI: 10.4251/wjgo.v17.i11.111814]
World J Gastrointest Oncol. Nov 15, 2025; 17(11): 111814 Published online Nov 15, 2025. doi: 10.4251/wjgo.v17.i11.111814
Personalized prognosis in unresectable hepatocellular carcinoma: Development and validation of a model for transcatheter arterial chemoembolization plus lenvatinib
Jia-Hui Yu, Jun Yu, Jin-Xin Yu, Lin-Feng Yang, Duan Yan, Yi Liu, Ju-Rui Xian, Peng-Sheng Yi
Jia-Hui Yu, Jun Yu, Lin-Feng Yang, Duan Yan, Yi Liu, Peng-Sheng Yi, Department of Hepato-Pancreato-Biliary II, National Clinical Key Specialty, Sub-center of National Clinical Research Center for Digestive Diseases, Sichuan Clinical Research Center for Digestive Diseases, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
Jin-Xin Yu, Ju-Rui Xian, Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
Author contributions: Yu JH and Yu J contributed to collect data; Yu JH and Yang LF contributed to data interpretation; Yu JH and Yi PS drafted and revised the manuscript; Yu JX and Liu Y contributed to the conception and design of the study; Yuan D and Xian JR contributed to statistical analyses; Yu JH and Yu J contributed equally to this manuscript and are co-first authors. All the authors have read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Approval No. 2025ER258-1).
Informed consent statement: Informed consent has been waived for this article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng-Sheng Yi, PhD, Department of Hepato-Pancreato-Biliary II, National Clinical Key Specialty, Sub-center of National Clinical Research Center for Digestive Diseases, Sichuan Clinical Research Center for Digestive Diseases, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong 637000, Sichuan Province, China. 13065256256@163.com
Received: July 10, 2025 Revised: September 13, 2025 Accepted: October 21, 2025 Published online: November 15, 2025 Processing time: 127 Days and 11.9 Hours
Abstract
BACKGROUND
Transcatheter arterial chemoembolization (TACE) combined with lenvatinib is an important modality for the treatment of unresectable hepatocellular carcinoma (HCC). To date, no prognostic analysis exists for clinical predictive models of TACE combined with lenvatinib in treating advanced unresectable HCC. A model was constructed through meta-analysis, and its validation was further enhanced by the collection of external clinical data, thereby providing guidance for clinical practice.
AIM
To identify risk factors for unresectable HCC following TACE plus lenvatinib therapy and to construct a clinical prediction model.
METHODS
We searched PubMed, Web of Science, EMBASE, and Cochrane Library databases for studies on TACE plus lenvatinib for unresectable HCC. Risk factors from the meta-analysis and sensitivity analyses were used to construct a prediction model. The validation set included clinical data from 106 eligible patients at the Affiliated Hospital of North Sichuan Medical College collected by June 1, 2023.
RESULTS
This study included 43 group studies involving 5070 patients. Tumor number, microvascular invasion, Eastern Cooperative Oncology Group performance status, Child-Pugh stage, Barcelona Clinic Liver Cancer stage, extrahepatic metastases, alpha-fetoprotein level, and hepatitis B virus status were risk factors for overall survival and progression-free survival, while triple therapy was a protective factor for both. In the validation set, the overall survival prediction model had area under the curve values of 0.616, 0.643, and 0.706 at 1 year, 2 years, and 3 years, respectively, and the progression-free survival model had area under the curve values of 0.702, 0.696, and 0.670 at the corresponding time points, demonstrating good model performance. Calibration curves, Kaplan-Meier survival analysis, and decision curves further validated the efficacy of the model.
CONCLUSION
Models based on nine variables from 43 group studies predicted the efficacy of TACE plus lenvatinib in unresectable HCC, supporting evidence-based clinical decisions and treatment strategies.
Core Tip: We summarized risk factors (number of tumors, microvascular invasion, Eastern Cooperative Oncology Group performance status, Child-Pugh stage, etc.) and protective factor (triple therapy) for unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus lenvatinib, constructed and validated prognostic models. In the validation set, area under the curve values of overall survival and progression-free survival, calibration curves, etc., confirmed their good performance, providing guidance for clinical practice.
