A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer

作者：Kadalayil L; Benini R; Pallan L; O' Beirne J; Marelli L; Yu D; Hackshaw A; Fox R; Johnson P; Burroughs A K; Palmer D H; Meyer T^*

来源：Annals of Oncology, 2013, 24(10): 2565-2570.

DOI：10.1093/annonc/mdt247

• embolization
• hepatocellular
• prognosis

The prognosis for patients with hepatocellular cancer (HCC) undergoing transarterial therapy (TACE/TAE) is variable. %26lt;br%26gt;We carried out Cox regression analysis of prognostic factors using a training dataset of 114 patients treated with TACE/TAE. A simple prognostic score (PS) was developed, validated using an independent dataset of 167 patients and compared with Child-Pugh, CLIP, Okuda, Barcelona Clinic Liver Cancer (BCLC) and MELD. %26lt;br%26gt;Low albumin, high bilirubin or alpha-fetoprotein (AFP) and large tumour size were associated with a two- to threefold increase in the risk of death. Patients were assigned one point if albumin %26lt; 36 g/dl, bilirubin %26gt; 17 mu mol/l, AFP %26gt; 400 ng/ml or size of dominant tumour %26gt; 7 cm. The Hepatoma arterial-embolisation prognostic (HAP) score was calculated by summing these points. Patients were divided into four risk groups based on their HAP scores; HAP A, B, C and D (scores 0, 1, 2 and %26gt; 2, respectively). The median survival for the groups A, B, C and D was 27.6, 18.5, 9.0 and 3.6 months, respectively. The HAP score validated well with the independent dataset and performed better than other scoring systems in differentiating high- and low-risk groups. %26lt;br%26gt;The HAP score predicts outcomes in patients with HCC undergoing TACE/TAE and may help guide treatment selection, allow stratification in clinical trials and facilitate meaningful comparisons across reported series.

• 出版日期2013-10