Individualized Surgical Guidance in HCC-BDTT

First Affiliated Hospital, Sun Yat-Sen University151 enrolled

Overview

The Rboost causal model can identify patients who are most likely to benefit among HCC-BDTT patients. Adherence to the individualized recommendation improves survival. This data-driven tool offers vital support for precision surgical decision-making in this high-risk disease.

This dual-center study recruited 151 HCC-BDTT patients who underwent radical hepatectomy (training cohort: 92; validation cohort: 59). An XGBoost-based R-learner (Rboost) algorithm was developed to estimate the individualized treatment effect (ITE) on 5-year overall survival (OS) between BDR and NBDR. Patients were stratified into ITE tertiles: BDR-recommended, ambiguous benefit, and NBDR-recommended. Model performance assessed with heterogeneity metrics (C-for-benefit, adjusted Qini index). Survival outcomes were compared within ITE strata between surgeries concordant and discordant with model recommendations (Kaplan-Meier/log-rank). Two-year disease-free survival (DFS) served as a treatment-proximal validity check.

Study Type

OBSERVATIONAL

Enrollment

151

Conditions

Hepatocellular Carcinoma (HCC)

Interventions

Bile Duct ResectionPROCEDURE

This group includes biliary/enteric reconstruction, bile duct resection with thrombectomy, and biliary tract interventions

Eligibility

Sex: ALLMin age: 31 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Pathologically confirmed HCC with BDTT; * Absence of extrahepatic malignancies at the time of HCC diagnosis; * Undergone R0 curative hepatectomy; * No prior antitumor therapies, such as chemotherapy or immunotherapy, before surgery; * Availability of preoperative imaging (CT or MRI) with standardized tumor evaluation. Exclusion Criteria: * Pathological findings indicating concurrent cholangiocarcinoma and HCC; * Loss to follow-up, preventing outcome evaluation, or insufficient clinical data for analysis. * Significant comorbidities (e.g., severe cardiac or renal failure) that could affect surgical outcomes.

Locations (1)

China, Guangdong

Guangzhou, Guangdong, China

Outcomes

Primary Outcomes

Treatment Effects

5-year overall survival (OS)

Time frame: 2025.09.01

Data from ClinicalTrials.gov

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