ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1609260
This article is part of the Research TopicLiver Cancer Awareness Month 2024: Current Progress and Future Prospects on Advances in Primary Liver Cancer Investigation and TreatmentView all 22 articles
Recurrence of hepatocellular carcinoma in patients with high HALP score in TACE combined with ablation
Provisionally accepted
- 1Beijing Youan Hospital, Capital Medical University, Beijing, Shaanxi Province, China
- 2Beijing Ditan Hospital, Capital Medical University, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objectives To investigate the relationship between the HALP score and recurrence in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) and ablation.We collected clinical data from 728 HCC patients who underwent TACE and ablation from January 2018 to December 2023. Patients with high HALP scores (H-HALP, n=422) were stratified into a training cohort (n=296) and an internal validation cohort (n=126), while an external validation cohort (n=147) was independently enrolled. Lasso-Cox regression was employed to identify independent risk factors for recurrencefree survival (RFS), and a nomogram was constructed. The predictive accuracy of nomogram was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results Although the median RFS in the H-HALP group longer than the L-HALP group (1.84 vs. 1.60 years, P=0.024), recurrence rates remained substantial in H-HALP patients (1-/3-/5-year RFS: 70.8%/36.2%/21.5%). The nomogram, integrating cirrhosis, tumor numbers, and γ-glutamyl transpeptidase (GGT), demonstrated moderate predictive accuracy for 1-/3-/5-year RFS in the training cohort (AUC: 0.665/0.694 /0.671) and internal validation cohort (AUC: 0.622/0.606/0.561). External validation yielded AUCs of 0.569 (1-year), 0.615 (3-year), and 0.662 (4-year). Calibration curves indicated strong agreement between predicted and observed outcomes, while DCA confirmed clinical utility. Risk stratification based on nomogram scores revealed significantly prolonged RFS in low-risk versus high-risk groups across all cohorts.The HALP score alone showed limited prognostic value in this cohort; however, the Lasso-Cox regression-based nomogram effectively stratified recurrence risk in H-HALP patients treated with TACE and ablation.
Keywords: Hepatocellular Carcinoma, HALP score, Lasso-Cox regression, Recurrence, nomogram
Received: 10 Apr 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Fang, Yin, Ding, Chen, Cui and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaoyan Ding, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Jinglong Chen, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Xiongwei Cui, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, Shaanxi Province, China
Caixia Hu, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, Shaanxi Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.