Transcatheter arterial chemoembolization plus lenvatinib toward precision prognostication for unresectable hepatocellular carcinoma

Table 1 Appraisal of the prognostic model and priorities for future validation

Domain	Strengths of current model	Limitations and future priorities
Evidence synthesis	Large-scale integration of 43 group studies encompassing 5070 patients	Underlying evidence base remains predominantly observational
Model variables	Successfully integrates nine readily available clinical parameters (e.g., tumor number, microvascular invasion, Child-Pugh stage, BCLC stage)	Lacks integration of dynamic molecular data and advanced imaging biomarkers
Population diversity	Validated externally with real-world clinical data	Skewed toward HBV-endemic regions; requires testing across geographically diverse cohorts and other etiologies (HCV, NASH)
Clinical utility	Demonstrates favorable discrimination relative to standard BCLC staging	Requires well-designed interventional studies to definitively test model-guided therapy outcomes

BCLC: Barcelona Clinic Liver Cancer Group; HBV: Hepatitis B virus; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis.