Jiachen Liu,1 Xiurong Ding,2 Yanyan Zhang,1 Hongjun Li1 

1Radiology Department, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China

Correspondence: Hongjun Li, Email lihongjun00113@ccmu.edu.cn

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% (p = 0.009), presence of satellite lesions (p = 0.026), GLR > 20 (p = 0.020), microvascular invasion (MVI) (p = 0.008), and Ki-67 expression > 50% (p < 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.

Keywords: hepatocellular carcinoma, postoperative adjuvant transarterial chemoembolization, early recurrence, nomogram