A Simple Prognostic Scoring System for Patients Receiving Transarterial Chemoembolization for Hepatocellular Carcinoma
Condition: Hepatocellular Carcinoma
MeSH terms: Carcinoma; Carcinoma, Hepatocellular
Study type: Observational

Summary: 
      Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and the third most
      frequent cause of death of cancer.Although with the development of medical science, more and
      more patients diagnose HCC at early stage, a lot of patients with HCC still continue to
      present with multiple tumors or port vein thrombosis. According to AASLD guidelines, these
      patients could received transcatheter arterial chemoembolization (TACE) or new agents as
      initial treatment. However, the intermediate group comprises a wide spectrum in terms of
      liver function and extent of tumour, and this may explain the large differences in survival
      reported for individual series.

      A simple, pragmatic and reliable prognostic index based on objective measures would be of
      value in providing information to patients, for stratifying patients entering clinical trials
      and in making meaningful comparisons between series reported in the literature.The aims of
      our study were (i) to identify predictors of survival in a cohort of patients undergoing TACE
      or TAE for unresectable HCC, (ii) to develop and validate a simple scoring system and (iii)
      to compare the new scoring system with the most frequently used prognostic systems for its
      ability to separate high- and low-risk patients.
    

Detailed description: 
      Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and the third most
      frequent cause of death of cancer. The 2005 guidelines of the American Association for the
      Study of Liver Diseases (AASLD) for HCC states that hepatic resection(HR) can be offered to
      patients with a solitary lesion if they are non-cirrhotic, or have cirrhosis but still have
      well-preserved liver function. With the improvement of surgical technique and perioperative
      care, the surgical mortality for HCC resection can be reduced to less than 1%, and the 5-year
      overall survival can exceed 50%. Although with the development of medical science, more and
      more patients diagnose HCC at early stage, a lot of patients with HCC still continue to
      present with multiple tumors or port vein thrombosis. According to AASLD guidelines, these
      patients could received transcatheter arterial chemoembolization (TACE) or new agents as
      initial treatment. However, the intermediate group comprises a wide spectrum in terms of
      liver function and extent of tumour, and this may explain the large differences in survival
      reported for individual series.

      A simple, pragmatic and reliable prognostic index based on objective measures would be of
      value in providing information to patients, for stratifying patients entering clinical trials
      and in making meaningful comparisons between series reported in the literature.The aims of
      our study were (i) to identify predictors of survival in a cohort of patients undergoing TACE
      or TAE for unresectable HCC, (ii) to develop and validate a simple scoring system and (iii)
      to compare the new scoring system with the most frequently used prognostic systems for its
      ability to separate high- and low-risk patients.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Patients with unresectable HCC received TACE.The diagnosis of HCC was confirmed by either
        histology, cytology, elevated alpha-fetoprotein (AFP, >400 ng/mL), or by typical
        radiological appearance.