药物洗脱珠经动脉化疗栓塞 (DEB-TACE) 后肝细胞癌 (HCC) 患者的最佳预后评估仍不清楚。本研究旨在提出一种新的分期系统，与当前 DEB-TACE 后 HCC 分期系统进行比较。来自四个中心，回顾性纳入接受 DEB-TACE 作为初始治疗的 HCC 患者，并将其分为训练集和验证集。使用多变量回归来确定训练集中的独立预后因素。提出了一种包含独立因素的新型分期系统，并在与两组中的其他分期系统相比的区分和校准方面进行了外部验证。训练集和验证集分别包括 335 名患者和 99 名患者。多变量回归揭示了独立​​因素，包括甲胎蛋白水平、天冬氨酸转氨酶与淋巴细胞计数比值指数、最大肿瘤直径、Child-Pugh分级和门静脉侵犯。提出了名为 PADCA 的新型预后分期系统，该系统在训练和验证集中具有最高的 C 指数、曲线下面积、Wald 测试值、临床获益和最低的 Akaike 信息标准，优于其他分期系统。与现有分期系统相比，分期系统具有优越的预后预测能力。 PADCA 可以帮助临床医生筛选出最有可能从 DEB-TACE 中获益的患者，并指导制定治疗和随访策略。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

The optimal prognostic assessment for patients with hepatocellular carcinoma (HCC) after drug-eluting bead transarterial chemoembolization (DEB-TACE) remains unclear. This study aimed to propose a novel staging system in comparison with the current staging systems for HCC following DEB-TACE.From four centers, patients with HCC undergoing DEB-TACE as the initial therapy were retrospectively included and classified into training and validation sets. Multivariable regression was used to determine the independent prognostic factors in the training set. A novel staging system incorporating the independent factors was proposed and externally validated in terms of discrimination and calibration compared to other staging systems in both sets.The training and validation sets included 335 and 99 patients, respectively. Multivariable regression revealed independent factors including alpha-fetoprotein level, aspartate aminotransferase to lymphocyte count ratio index, maximum tumor diameter, Child-Pugh class, and portal vein invasion. The novel prognostic staging system, named PADCA, was proposed and outperformed other staging systems with the highest C-index, area under the curve, Wald test value, clinical benefit, and the lowest Akaike information criterion in the training and validation sets.The PADCA staging system has a superior prognostic predictive ability compared to the current staging systems. PADCA can assist clinicians in screening out the patients most likely to derive benefit from DEB-TACE and guiding the formulation of therapy and follow-up strategy.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.