Early Recurrent Hepatocellular Carcinoma with CK19 Positive Receiving Transarterial Chemoembolization After Surgical Resection: A Novel Risk Model Study.

[OBJECTIVE] To evaluate the benefit of nomogram-based model for predicting response and survival in patients with early recurrent hepatocellular carcinoma after hepatic resection by CK19 positive expression treated with transarterial chemoembolization (TACE).

[MATERIALS AND METHODS] We retrospectively analyzed 82 patients with early recurrent HCC expressing CK19 positivity after hepatectomy who underwent TACE between January 2014 and December 2023. OS and PFS were compared using the Kaplan-Meier method and Log rank test. Based on the COX regression results, independent predictors were identified from them. These factors were used to construct a nomogram model. The discriminatory, predictive efficacy of this model was assessed using receiver operating characteristic curves (ROC), calibration curves, and internal validation.

[RESULTS] CK19 expression grade and distant metastasis were independent prognostic risk factors, and the number of TACE sessions and whether it was combined with systemic therapy were prognostic protective factors, and survival after resection was strongly correlated with the CK19 grade. Compared with TACE alone, TACE combined with targeted and immunotherapy provided more survival benefit for patients with CK19-positive postoperative recurrence. The nomogram model has promising predictive efficacy.

[CONCLUSION] We constructed a validated tool for the prognosis of patients with postoperative recurrence of hepatocellular carcinoma, which helps to identify the risk level of hepatocellular carcinoma recurrence and optimize the treatment as early as possible in the clinic, and brings survival benefit to patients.