A Simple Prognostic Scoring System for Hepatocellular Carcinoma Treated with Selective Internal Radiation Therapy

Area of Science:

• Hepatobiliary Surgery
• Interventional Radiology
• Oncology

Background:

• Selective Internal Radiation Therapy (SIRT) is a localized treatment for hepatocellular carcinoma (HCC).
• The optimal role of SIRT alongside other HCC therapies requires further definition.
• A specific prognostic score is needed to identify suitable candidates for SIRT.

Purpose of the Study:

• To develop and validate a prognostic score tailored for hepatocellular carcinoma (HCC) patients undergoing Selective Internal Radiation Therapy (SIRT).
• To identify independent prognostic factors for HCC patients treated with SIRT.

Main Methods:

• Retrospective analysis of 72 HCC patients treated with SIRT at the University Hospital of Munich.
• Assessment of 12 existing HCC staging systems and prognostic scores.
• Cox-regression analysis to identify independent prognostic factors for the Munich-SIRT (M-SIRT) score.
• External validation of the M-SIRT score in a separate cohort of 128 SIRT patients from the University Hospital of Pamplona.

Main Results:

• Alpha-fetoprotein (AFP), albumin, and alkaline phosphatase were identified as independent prognostic factors.
• The M-SIRT score created three distinct prognostic groups with significantly different median survival times (38.9, 14.6, and 7.7 months).
• M-SIRT demonstrated superior prognostic performance (c-Index: 0.711) compared to established HCC staging systems and was successfully validated externally.

Conclusions:

• Therapy-specific prognostic scores are valuable for guiding treatment decisions and improving prognostication in HCC patients.
• The M-SIRT score shows promise as a reliable prognostic tool for HCC patients considered for SIRT, based on its performance in a combined cohort of 200 patients.