The effect of adjuvant transarterial chemoembolization for hepatocellular carcinoma after liver resection based on risk stratification

Background:There is currently no standard adjuvant treatment proven to prevent hepatocellular carcinoma(HCC)recurrence.Recent studies suggest that postoperative adjuvant transarterial chemoembolization(PA-TACE)is beneficial for patients at high risk of tumor recurrence.However,it is difficult to select the patients.The present study aimed to develop an easy-to-use score to identify these patients.Methods:A total of 4530 patients undergoing liver resection were recruited.Independent risk factors were identified by Cox regression model in the training cohort and the Primary liver cancer big data transarterial chemoembolization(PDTE)scoring system was established.Results:The scoring system was composed of ten risk factors including alpha-fetoprotein(AFP),albuminbilirubin(ALBI)grade,operative bleeding loss,resection margin,tumor capsular,satellite nodules,tumor size and number,and microvascular and macrovascular invasion.Using 5 points as risk stratification,the patients with PA-TACE had higher recurrence-free survival(RFS)compared with non-TACE in>5 points group(P<0.001),whereas PA-TACE patients had lower RFS compared with non-TACE in≤5 points group(P=0.013).In the training and validation cohorts,the C-indexes of PDTE scoring system were 0.714[standard errors(SE)=0.010]and 0.716(SE=0.018),respectively.Conclusions:The model is a simple tool to identify PA-TACE for HCC patients after liver resection with a favorable performance.Patients with>5 points may benefit from PA-TACE.

Genesis and mechanisms of organic matter enrichment of the Hongshuizhuang Formation in the Zhoukoudian area of Jingxi sag,North China

The Hongshuizhuang Formation is a Meso-Neoproterozoic high-quality source rock in the North China Craton(NCC),comprising abundant organic matter.The present study focuses on the analysis of the Hongshuizhuang Formation in the Zhoukoudian area of the Jingxi sag,discussing its genesis and mechanisms of organic matter enrichment through geological and geochemical methods.The Hongshuizhuang Formation is divided into three members from bottom to top respectively as the lower,middle and upper member.Trace elements analysis indicate that the Hongshuizhuang Formation developed restricted neritic facies in an extensional environment within a continental island arc under a post-orogenic background.The lower and upper members were deposited in a relatively shallow,strongly retained water mass within a suboxic and saline environment influenced by subhumid climate,while the middle member was deposited in an anoxic deep-water environment with relatively low salinity and weak restrictions.The PAAS-normalized rare earth element distributions of the middle and upper members show an enrichment of LREEs and a depletion of HREEs,and a low mean Y/Ho ratio with a positive Eu anomaly,indicating that the regional deposition has been affected by hydrothermal fluids.The negativeδ13 C andδ18 O values and the positive87 Sr/86 Sr values confirm that the deposition of the middle and upper members was accompanied by crustal hydrothermal activities.Accumulation of organic matter and enrichment of Baxsand P indicate that productivity is the basis of organic matter enrichment in the Hongshuizhuang Formation,where high-quality source rocks are concentrated in the middle member.In addition,reduced water mass controls the preservation of organic matter.Hydrothermal activity,humid climate,and salinity support a higher primary productivity and the formation of reduced water masses.However,due to limitations in depth,the high-quality source rocks in the Jingxi sag are thinner than the Jibei sag.