ArticleJHEP reports : innovation in hepatology2025
Tumor burden with AFP improves survival prediction for TACE-treated patients with HCC: An international observational study
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Article in JHEP reports : innovation in hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8citing papers in PubMed
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Who cites it
8 citing papers in PubMed.
- Prognostic outcomes of surgery vs. non-surgery in initially unresectable HCC with successful conversion via ICI + TKI therapy.BMC gastroenterology · 2026Article
- A novel clinical FIT model predicts prognosis of unresectable hepatocellular carcinoma treated with TACE combined with lenvatinib and PD-1 inhibitors therapy.Frontiers in immunology · 2026Article
- AAT score based on pretreatment indicators predicts outcomes in unresectable HCC patients treated with TACE, Sintilimab, and Bevacizumab.Frontiers in oncology · 2026Article
- Downstaging therapy of intermediate-stage hepatocellular carcinoma: microwave ablation vs. surgical resection.Frontiers in oncology · 2026Article
- Transarterial chemoembolization combined with PD-1 inhibitors for unresectable hepatocellular carcinoma: efficacy and hepatic safety at 4-week versus 6-week treatment intervals.American journal of translational research · 2026Article
- Complexity in Steatotic Liver Disease: Rethinking Thresholds and the Synergistic Effect of Risk Factors.Digestive diseases and sciences · 2025Article
- Optimizing TACE for Hepatocellular Carcinoma: The Impact of Intra-Arterial Contrast Enhanced Ultrasound.Diagnostics (Basel, Switzerland) · 2025Review
- A Clinical-Radiomics Nomogram Predicts Early Tumor Necrosis After Transarterial Chemoembolization for Hepatocellular Carcinoma.Technology in cancer research & treatmentArticle
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Authors and funding
87 authors.
Dongdong XiaState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Wei BaiDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Qiuhe WangDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Jin Wook ChungDepartment of Radiology, Seoul National University Hospital, Seoul, Korea.
Xavier AdhouteDepartment of Gastroenterology and Hepatology, Hôpital Saint-Joseph, Marseille, France.
Roman KloecknerDepartment of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckst, Mainz, Germany.
Hui ZhangDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
Yong ZengDepartment of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Pimsiri SripongpunGastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Chunhui NieDepartment of Hepatobiliary and Pancreatic Interventional Cancer, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Seung Up KimDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Ming HuangDepartment of Minimally Invasive International Therapy, The Third Affiliated Hospital of Kunming University, Tumor Hospital of Yunnan Province, Kunming, China.
Wenhao HuDepartment of Interventional Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Xiangchun DingDepartment of Infectious Disease, General Hospital of Ningxia Medical University, Yinchuan, China.
Guowen YinDepartment of Interventional Radiology, Jiangsu Provincial Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Hailiang LiDepartment of Interventional Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Hui ZhaoDepartment of Interventional Radiology, The Affiliated Hospital of Nantong University, Nantong, China.
Jean-Pierre BronowickiDepartment of Gastroenterology and Hepatology, Centre Hospitalo-Universitaire de Nancy, France.
Jing LiDepartment of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Jiaping LiDepartment of Interventional Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Xiaoli ZhuDepartment of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Jianbing WuDepartment of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Chunqing ZhangDepartment of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Jinan, China.
Weidong GongDepartment of Interventional Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Zixiang LiInterventional Medical Centre of the Affiliated Hospital of Qingdao University, Qingdao, China.
Zhengyu LinDepartment of Interventional Radiology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Tao XuDepartment of Infectious Diseases, the 910 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Quanzhou, China.
Tao YinDepartment of Hepatic & Biliary & Pancreatic Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Rodolphe AntyDepartment of Gastroenterology and Hepatology, Hôpital Universitaire de l'Archet Nice, France.
Jinlong SongDepartment of Interventional Therapy, Shandong Tumor Hospital, Jinan, China.
Haibin ShiDepartment of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Guoliang ShaoDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou, China.
Weixin RenDepartment of Interventional Radiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Yongjin ZhangDepartment of Interventional Radiology and Vascular Surgery, Hunan Provincial People's Hospital, Changsha, China.
Shufa YangDepartment of Interventional Radiology, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China.
Yanbo ZhengDepartment of Interventional Radiology, Yantai Yuhuangding Hospital, Yantai, China.
Jian XuDepartment of Medical Imaging, Nanjing General Hospital of the Nanjing Military Command, Nanjing, China.
Wenhui WangDepartment of Interventional Medicine, The First Affiliated Hospital of Lanzhou University, Lanzhou, China.
Xu ZhuDepartment of Interventional Radiology, Peking University Cancer Hospital, Beijing, China.
Ying FuDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
Chang LiuDepartment of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Apichat KaewdechGastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Rong DingDepartment of Minimally Invasive International Therapy, The Third Affiliated Hospital of Kunming University, Tumor Hospital of Yunnan Province, Kunming, China.
Jie ZhengDepartment of Interventional Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Shuaiwei LiuDepartment of Infectious Disease, General Hospital of Ningxia Medical University, Yinchuan, China.
Hui YuDepartment of Interventional Radiology, Jiangsu Provincial Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Lin ZhengDepartment of Interventional Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Nan YouDepartment of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Wenzhe FanDepartment of Interventional Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Shuai ZhangDepartment of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Long FengDepartment of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Guangchuan WangDepartment of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Jinan, China.
Peng ZhangDepartment of Interventional Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Xueda LiInterventional Medical Centre of the Affiliated Hospital of Qingdao University, Qingdao, China.
Jian ChenDepartment of Interventional Radiology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Feng ZhangDepartment of Hepatic & Biliary & Pancreatic Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Wenbo ShaoDepartment of Interventional Therapy, Shandong Tumor Hospital, Jinan, China.
Weizhong ZhouDepartment of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Hui ZengDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou, China.
Gengfei CaoDepartment of Interventional Radiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Wukui HuangDepartment of Interventional Radiology, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China.
Wenjin JiangDepartment of Interventional Radiology, Yantai Yuhuangding Hospital, Yantai, China.
Wen ZhangDepartment of Medical Imaging, Nanjing General Hospital of the Nanjing Military Command, Nanjing, China.
Lei LiDepartment of Interventional Medicine, The First Affiliated Hospital of Lanzhou University, Lanzhou, China.
Aiwei FengDepartment of Interventional Radiology, Peking University Cancer Hospital, Beijing, China.
Enxin WangDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Zhexuan WangDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Dandan HanDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Yong LvState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Jun SunDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Bincheng RenDepartment of Rheumatology and Immunology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Linying XiaDepartment of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Xiaomei LiDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Jie YuanDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Zhengyu WangDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Bohan LuoDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Kai LiState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Wengang GuoDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Zhanxin YinDepartment of Liver Diseases and Interventional Radiology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Yan ZhaoDepartment of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi'an International Medical Center Hospital, Northwest University, Xi'an, China.
Jielai XiaDepartment of Health Statistics, Fourth Military Medical University, Xi'an, China.
Daiming FanState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Kaichun WuState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Dominik BettingerDepartment of Medicine II, University Medical Center Freiburg, Freiburg, Germany.
Arndt VogelDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Guohong HanState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
China HCC-TACE study group
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: Current prognostic models for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) are not extensively validated and widely accepted. We aimed to develop and validate a continuous model incorporating tumor burden and biology for individual survival prediction and risk stratification. Methods: Overall, 4,377 treatment-naive candidates for whom TACE was recommended, from 39 centers in five countries, were enrolled and divided into training, internal validation, and two external validation datasets. The novel model was developed using a Cox multivariable regression analysis and compared with our original 6-and-12 model (the largest tumor size [ts, centimetres] + tumor number [tn]) and other available models in terms of predictive accuracy. Results: The proposed model, named the '6-and-12 model 2.0', was generated as 'ts + tn + 1.5×log Conclusions: The 6-and-12 model 2.0 significantly improved individual outcome predictions and better stratified the candidates recommended for TACE; thus, this model could be used in both clinical practice and trial design. Impact and implications: In this international multicentre study, we developed and internally and externally validated a novel outcome prediction model for candidates with HCC who would be ideal for TACE. The model, called the 6-and-12 model 2.0, was based on 4,377 patients from 39 centers in five countries. The model offers individualized outcome prediction, outperforming the original 6-and-12 model score and other existing metrics across all datasets and subsets. Based on different levels of alpha-fetoprotein (AFP) and corresponding cut-offs of tumor burden, patients could be stratified into three risk strata with significantly different survival prognoses, which could provide a referential framework to control study heterogeneity and define the target population in future trial designs.
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Alpha-fetoproteinHepatocellular carcinomaRisk stratificationTransarterial chemoembolizationTumor burden
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