SR-HCC Score: A Novel Nomogram for Predicting Spontaneous Rupture in Hepatocellular Carcinoma Patients

Area of Science:

• Hepatology
• Oncology
• Medical Diagnostics

Background:

• Spontaneous rupture of hepatocellular carcinoma (srHCC) is a critical complication with high mortality.
• Currently, no integrated predictive tool exists for stratifying srHCC risk.
• Early identification of high-risk patients is crucial for timely intervention.

Purpose of the Study:

• To develop and validate a novel nomogram, the SR-HCC score, for predicting srHCC risk.
• To integrate clinical, radiological, and laboratory parameters into a predictive model.
• To provide a user-friendly tool for individualized risk stratification.

Main Methods:

• Retrospective cohort study of 186 HCC patients, split into training (80%) and validation (20%) sets.
• Logistic regression analyses identified independent predictors of srHCC.
• Nomogram performance evaluated using Receiver Operating Characteristic (ROC) curves and calibration plots.

Main Results:

• Key predictors included tumor diameter, number of tumors, capsular protrusion, Alpha-Fetoprotein (AFP) levels, and changes in ALT and AST.
• The SR-HCC score demonstrated excellent discrimination (AUC = 0.9617 training, 0.9630 validation).
• The nomogram showed good calibration, with predicted probabilities closely matching observed outcomes.

Conclusions:

• The SR-HCC score is a reliable and user-friendly tool for srHCC risk stratification.
• This tool can guide preventive interventions and surveillance strategies, particularly in resource-limited settings.
• Implementing the SR-HCC score can potentially improve patient outcomes by preventing catastrophic ruptures.