Comparative liver function models for ruptured hepatocellular carcinoma: A 10-year single center experience

Area of Science:

• Hepatology
• Oncology
• Medical Statistics

Background:

• Objective liver function assessment is vital for hepatocellular carcinoma (HCC) patients.
• The predictive value of existing models for HCC rupture survival remains unclear.
• This study evaluates liver function models specifically for ruptured HCC.

Purpose of the Study:

• To determine the most effective liver function model for predicting survival in patients with ruptured HCC.
• To compare the performance of Child-Pugh (CP) score and ALBI score in this context.

Main Methods:

• Analysis of 230 patients with ruptured HCC.
• Kaplan-Meier and Cox regression for survival and mortality analysis.
• Area Under the Receiver Characteristic Curve (AUC) to compare 90-day mortality prediction accuracy.

Main Results:

• Child-Pugh (CP) score significantly predicted overall survival (OS) in all subgroups (P < 0.0001).
• ALBI score showed no statistical significance in surgical (P = 0.8985) or non-surgical (P = 0.0634) subgroups.
• CP score demonstrated superior performance in predicting 90-day mortality (AUCs ranging from 0.558 to 0.746) compared to ALBI score (AUCs ranging from 0.530 to 0.712).
• Logistic models with CP or MELD showed better discrimination for 90-day mortality than ALBI.

Conclusions:

• Child-Pugh (CP) or MELD scores are recommended for liver function classification in ruptured HCC.
• ALBI score is less suitable for assessing liver function in ruptured HCC patients.
• These findings can guide clinical management and prognostic assessment for ruptured HCC.