Faculty, Staff and Student Publications

Publication Date

6-3-2024

Journal

The Oncologist

Abstract

Background: Accurate prognostic stratification of hepatocellular carcinoma (HCC) is vital for clinical trial enrollment and treatment allocation. Multiple scoring systems have been created to predict patient survival, but no standardized scoring systems account for radiologic tumor features. We sought to create a generalizable scoring system for HCC which incorporates standardized radiologic tumor features and more accurately predicts overall survival (OS) than established systems.

Methods: Clinicopathologic parameters were collected from a prospectively collected cohort of patients with HCC treated at a single institution. Imaging studies were evaluated for tumor characteristics. Patients were randomly divided into a training set for identification of covariates that impacted OS and a validation set. Cox models were used to determine the association of various factors with OS and a scoring system was created.

Results: We identified 383 patients with HCC with imaging and survival outcomes, n = 255 in the training set and 128 in the validation cohort. Factors associated with OS on multivariate analysis included: tumor margin appearance on CT or MRI (hazard ratio [HR] 1.37, 95% CI, 1.01-1.88) with infiltrative margins portending worse outcomes than encapsulated margins, massive tumor morphology (HR 1.64, 95% CI, 1.06-2.54); >2 lesions (HR 2.06, 95% CI, 1.46-2.88), Child-Turcotte-Pugh class C (HR 3.7, 95% CI, 2.23-6.16), and portal vein thrombus (HR 2.41, 95% CI, 1.71-3.39). A new scoring system was developed and more predictive of OS than other well-established systems.

Conclusions: Incorporation of standardized imaging characteristics to established clinical and lab predictors of outcome resulted in an improved predictive scoring system for patients with HCC.

Keywords

Humans, Carcinoma, Hepatocellular, Liver Neoplasms, Male, Female, Prognosis, Middle Aged, Aged, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Adult, Proportional Hazards Models, Prospective Studies, hepatocellular carcinoma, prognosis, digestive system neoplasms, liver neoplasms, radiology

DOI

10.1093/oncolo/oyad329

PMID

38159256

PMCID

PMC11144988

PubMedCentral® Posted Date

12-30-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

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