A machine learning-based decision support model for selecting intra-arterial therapy for unresectable hepatocellular carcinoma: a nationwide real-world evidence-based study

Machine Learning


  • Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram L, Jemal A, et al. World cancer statistics 2020: GLOBOCAN estimates of incidence and mortality for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49. https://doi.org/10.3322/caac.21660.

    Article CAS PubMed Google Scholar

  • Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guideline from the American Association for the Study of Liver Diseases. Hepatology. 2018;68:723–50. https://doi.org/10.1002/hep.29913.

    Article PubMed Google Scholar

  • Villanueva A. Hepatocellular carcinoma. N Engl J Med. 2019;380:1450–62. https://doi.org/10.1056/NEJMra1713263.

    Article CAS PubMed Google Scholar

  • Park JW, Chen M, Colombo M, Roberts LR, Schwartz M, Chen PJ, et al. Global patterns of hepatocellular carcinoma treatment from diagnosis to death: the BRIDGE study. Liver Int. 2015;35:2155–66. https://doi.org/10.1111/liv.12818.

    Article PubMed PubMed Central Google Scholar

  • Ghanaati H, Mohammadifard M, Mohammadifard M. A review on the application of transarterial chemoembolization (TACE) technique in the treatment of hepatocellular carcinoma. J Fam Med Prim Care. 2021;10:3553–60. https://doi.org/10.4103/jfmpc.jfmpc_2347_20.

    Article Google Scholar

  • Sidaway P. HAIC-FO improves outcomes in HCC. Nat Rev Clin Oncol. 2022;19:150. https://doi.org/10.1038/s41571-022-00599-0.

    Article CAS PubMed Google Scholar

  • He M, Li Q, Zou R, Shen JX, Fang WQ, Tan GS, et al. Hepatic arterial infusion of sorafenib plus oxaliplatin, fluorouracil, and leucovorin versus sorafenib alone for hepatocellular carcinoma with portal vein invasion: a randomized clinical trial. JAMA Oncol. 2019;5:953–60. https://doi.org/10.1001/jamaoncol.2019.0250.

    Article PubMed PubMed Central Google Scholar

  • Zhang Z, Li C, Liao W, Huang Y, Wang ZA. Comparison of immune checkpoint inhibitor sorafenib, TACE, and stereotactic radiosurgery combined with sorafenib plus TACE in advanced hepatocellular carcinoma with portal vein tumor thrombus. Cancers. 2022;14. https://doi.org/10.3390/cancers14153619.

  • Lencioni R, Llovet JM, Han G, Tak WY, Yang JM, Alfredo G, et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate-stage HCC: the SPACE trial. J Hepatol. 2016;64:1090–8. https://doi.org/10.1016/j.jhep.2016.01.012.

    Article CAS PubMed Google Scholar

  • McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology. 2021;73:4–13. https://doi.org/10.1002/hep.31288.

    Article CAS PubMed Google Scholar

  • An C, Zuo M, Li W, Chen Q, Wu P. Invasive hepatocellular carcinoma: transcatheter arterial chemoembolization versus hepatic arterial infusion chemotherapy. Front Oncol. 2021;11:747496. https://doi.org/10.3389/fonc.2021.747496.

    Article CAS PubMed PubMed Central Google Scholar

  • An C, Yao W, Zuo M, Li W, Chen Q, Wu P. Pseudocapsular hepatocellular carcinoma: hepatic arterial infusion chemotherapy versus transcatheter arterial chemoembolization. Acad Radiol. 2023. https://doi.org/10.1016/j.acra.2023.06.021.

  • Kourou K, Exarchos TP, Exarchos KP, Karamouzis MV, Fotiadis DI. Applications of machine learning in cancer prognosis and prediction. Comput Struct Biotechnol J. 2015;13:8–17. https://doi.org/10.1016/j.csbj.2014.11.005.

    Article CAS PubMed Google Scholar

  • An C, Yang H, Yu X, Han Z, Cheng Z, Liu F, et al. A health record-based machine learning model for predicting recurrence after microwave ablation of hepatocellular carcinoma. J Hepatocell Carcinoma. 2022;9:671–84. https://doi.org/10.2147/JHC.S358197.

    Article PubMed PubMed Central Google Scholar

  • Uche-Anya E, Anyane-Yeboa A, Berzin TM, Ghassemi M, May FP. Artificial intelligence in gastroenterology and hepatology: how to advance clinical practice while ensuring health equity. Gut. 2022;71:1909–15. https://doi.org/10.1136/gutjnl-2021-326271.

    Article PubMed Google Scholar

  • Moons KGM, Altman DG, Reitsma JB, Ioannidis JPA, Macaskill P, Steyerberg EW. Transparent reporting of multivariate predictive models for individual prognosis or diagnosis (TRIPOD): description and details. Ann Intern Med. 2015;162:W1–73. https://doi.org/10.7326/M14-0698. January 6.

    Article PubMed Google Scholar

  • EASL Clinical Practice Guideline: Management of Hepatocellular Carcinoma. J Hepatol2018;69:182-236. Source: https://doi.org/10.1016/j.jhep.2018.03.019.

  • Cardella JF, Kundu S, Miller DL, Millward SF, Sacks D. Society of Interventional Radiology Clinical Practice Guideline. J Vasc Inter Radio. 2009;20:S189–191. https://doi.org/10.1016/j.jvir.2009.04.035.

    Article Google Scholar

  • Liu W, Wei R, Chen J, Li Y, Pang H, Zhang W, et al. Machine learning-based prognostic prediction and risk stratification of transarterial chemoembolization or intra-arterial chemotherapy for unresectable hepatocellular carcinoma. Eur Radiol. 2024-01-30. https://doi.org/10.1007/s00330-024-10581-2.

    Article PubMed Google Scholar

  • Wang K, Tian J, Zheng C, Yang H, Ren J, Liu Y, et al. Interpretable prediction of 3-year all-cause mortality in patients with heart failure due to coronary artery disease based on machine learning and SHAP. Comput Biol Med. 2021;137:104813. https://doi.org/10.1016/j.compbiomed.2021.104813.

    Article PubMed Google Scholar

  • Ma M, Liu R, Wen C, Xu W, Xu Z, Wang S, et al. Predicting molecular subtypes of breast cancer and identifying interpretable image features using machine learning algorithms. Eur Radiol. 2022;32:1652–62. https://doi.org/10.1007/s00330-021-08271-4.

    Article CAS PubMed Google Scholar

  • Li QJ, He MK, Chen HW, Fang WQ, Zhou WM, Liu X, et al. Hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin versus transarterial chemoembolization for bulky hepatocellular carcinoma: a randomized phase III trial. J Clin Oncol. 2022;40:150–60. https://doi.org/10.1200/JCO.21.00608.

    Article CAS PubMed Google Scholar

  • Jin ZC, Zhong BY, Chen JJ, Zhu HD, Sun JH, Yin GW, et al. Real-world efficacy and safety of TACE plus camrelizumab plus apatinib in patients with HCC (CHANCE2211): a propensity score matching study. Eur Radiol. 2023. https://doi.org/10.1007/s00330-023-09754-2.

  • Johnson PJ, Berhane S, Kagebayashi C, Shinji S, Mabel T, Helen LR, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach – ALBI grading. J Clin Oncol. 2015;33:550–8. https://doi.org/10.1200/JCO.2014.57.9151.

    Article PubMed Google Scholar

  • Reig M, Forner A, Rimola J, Joana F, Marta B, Ángeles G, et al. BCLC strategies for prognostic prediction and treatment recommendations: 2022 update. J Hepatol. 2022;76:681–93. https://doi.org/10.1016/j.jhep.2021.11.018.

    Article PubMed Google Scholar

  • Song S, Bai M, Li X, Guo S, Yang W, Li C, et al. Early predictive value of circulating biomarkers of sorafenib in advanced hepatocellular carcinoma. Expert Rev Mol Diagn. 2022;22:361–78. https://doi.org/10.1080/14737159.2022.2049248.

    Article CAS PubMed Google Scholar

  • Hiraoka A, Ishimaru Y, Kawasaki H, Aibiki T, Okudaira T, Toshimori A, et al. Tumor markers AFP, AFP-L3, and DCP in hepatocellular carcinoma refractory to transcatheter arterial chemoembolization. Oncology. 2015;89:167–74. https://doi.org/10.1159/000381808.

    Article CAS PubMed Google Scholar

  • Zhou H, Song T. Conversion and maintenance therapy for primary hepatocellular carcinoma. Biosci Trends. 2021;15:155–60. https://doi.org/10.5582/bst.2021.01091.

    Article CAS PubMed Google Scholar

  • Fan J, Tang ZY, Yu YQ, Wu ZQ, Ma ZC, Zhou XD, et al. Improved survival with resection after transcatheter arterial chemoembolization (TACE) for unresectable hepatocellular carcinoma. Dig Surg. 1998;15:674–8. https://doi.org/10.1159/000018676.

    Article CAS PubMed Google Scholar

  • Shi F, Lian S, Mai Q, Mo ZQ, Zhuang WH, Cui W, et al. Microwave ablation after downstaging of hepatocellular carcinoma: outcomes were similar to tumors within the Milan criteria. Eur Radiol. 2020;30:2454–62. https://doi.org/10.1007/s00330-019-06604-y.

    Article PubMed Google Scholar

  • Binnewies M, Roberts EW, Kersten K, Vincent C, Douglas FF, Miriam M, et al. Understanding the tumor immune microenvironment (TIME) for effective treatment. Nat Med. 2018;24:541–50. https://doi.org/10.1038/s41591-018-0014-x.

    Article CAS PubMed PubMed Central Google Scholar

  • Cao J, Su B, Peng R, Tang H, Tu DY, Tang YH, et al. Bioinformatics analysis of immune infiltration and TRIM family genes in hepatocellular carcinoma. J Gastrointest Oncol. 2022;13:1942–58. https://doi.org/10.21037/jgo-22-619.

    Article PubMed PubMed Central Google Scholar

  • Liu F, Liu D, Wang K, Xie XH, Su LY, Kuang M, et al. Contrast ultrasound-based deep learning radiomics may optimize treatment for patients with very early or early stage hepatocellular carcinoma. Liver Cancer. 2020;9:397–413. https://doi.org/10.1159/000505694.

    Article PubMed PubMed Central Google Scholar

  • Ding W, Wang Z, Liu FY, Cheng ZG, Yu XL, Han ZY, et al. A semantic-informed hybrid machine learning model can optimize treatment decisions for patients with untreated 3-5 cm single HCC. Liver Cancer. 2022;11:256–67. https://doi.org/10.1159/000522123.

    Article CAS PubMed PubMed Central Google Scholar



  • Source link

    Leave a Reply

    Your email address will not be published. Required fields are marked *