A Nomogram Model for Predicting the Response to Transcatheter Arterial Embolization in Patients With Symptomatic Hepatic Hemangioma

Abstract Background: Transcatheter arterial embolization (TAE) was regarded as an effective treatment in patients with symptomatic hepatic hemangioma. However, few studies have evaluated the efficacy of TAE alone for hepatic hemangioma. The aim of the study is to identify the factors that influence the response to TAE and formulate a quantitative nomogram to optimize the individualized management for hepatic hemangioma. Methods: We retrospectively studied 276 patients treated with TAE for hepatic hemangioma at our center from January 2011 to December 2019. The cohort was randomly divided into training and validation cohort. After assessing the potential predictive factors for the efficacy of TAE in the training cohort, a nomogram model was established and evaluated by discrimination and calibration. Results: The symptom relief rate was 100% during the course of follow-up. The tumor blood supply (p < 0.001), tumor number (p = 0.004) and tumor size (p = 0.006) were identified significant predictors to the failure of tumor shrinkage in response to TAE. The nomogram model showed favorable discrimination and calibration, with a C-index of 0.775 (95% CI, 0.705 to 0.845) in the training cohort, which was further confirmed in the validation cohort (C-index 0.768; 95% CI, 0.680 to 0.856). The side effects of TAE were relatively minor and mainly included abdominal pain, nausea, vomiting, fever and the presence of elevated hepatic transaminases. Conclusion: TAE is safe and effective in the treatment of symptomatic hepatic hemangioma. The established nomogram performed well for the estimation of the effect of TAE in patients with hepatic hemangioma and would facilitate the optimal patient selection.