AFP-DIAM Score to Predict Survival in Patients with Hepatocellular Carcinoma Before TACE: A French Multicenter Study

Area of Science:

• Hepatocellular Carcinoma (HCC) Research
• Interventional Oncology
• Prognostic Biomarker Development

Background:

• Transarterial chemoembolization (TACE) is a standard palliative treatment for Barcelona Clinic Liver Cancer (BCLC) B-stage hepatocellular carcinoma (HCC).
• Accurate prognostication is crucial for guiding therapeutic strategies in HCC management.
• Existing prognostic models may not fully capture the complexity of patient outcomes following TACE.

Purpose of the Study:

• To identify predictors of survival in patients with HCC undergoing TACE.
• To develop and validate a novel pre-therapeutic prognostic score for TACE patients.
• To compare the performance of the new score against existing prognostic tools.

Main Methods:

• Retrospective analysis of 191 adult cirrhotic patients with HCC treated with TACE.
• Investigation of baseline liver function, patient characteristics, and tumor burden as prognostic factors.
• Development and external validation of the AFP-DIAM prognostic score.

Main Results:

• The AFP-DIAM score significantly stratified patients into two distinct survival groups (median OS 28.3 vs. 17.7 months).
• AFP-DIAM demonstrated superior discrimination (C-index) compared to NIACE, HAP, STATE, and SIX TO TWELVE scores.
• AFP-DIAM and SIX TO TWELVE were identified as the most user-friendly scores, with AFP-DIAM showing better performance in head-to-head comparison.

Conclusions:

• The AFP-DIAM score is a simple and effective tool for predicting prognosis in HCC patients prior to TACE.
• AFP-DIAM can aid clinicians in refining treatment strategies and supporting the BCLC staging system.
• This score offers valuable insights for personalized HCC management.