Novel comprehensive hepatocellular carcinoma outcome prognostic scoring system

Accurate prognostic stratification of hepatocellular carcinoma (HCC) is important for treatment allocation. Multiple scoring systems have been created to predict patient survival, but no standardized scoring systems account for radiologic tumor features. Researchers at MD Anderson Cancer Center (Houston, TX) created a generalizable scoring system for HCC which incorporates standardized radiologic tumor features aiming to more accurately predict overall survival (OS) than established systems. The study included 255 patients in the training set for identification of covariates that impacted OS and 128 patient in the validation cohort. Factors associated with OS in multivariate analysis were: tumor margin appearance on CT or MRI (HR 1.37; 95% CI 1.01-1.88), massive tumor morphology (1.64; 1.06-2.54), more than 2 lesions (2.06; 1.46-2.88), Child-Turcotte-Pugh class C (3.7; 2.23-6.16), and portal vein thrombosis (2.41; 1.71-3.39). Based on these factors, a new scoring system was developed (MD Anderson Comprehensive HCC Outcomes Prognostic Score; MDA CHOP) which was more predictive of OS than other well-established systems.