Comparison of Prognostic Scores in Patients With Hepatocellular Carcinoma Treated With Sorafenib.

Abstract

INTRODUCTION:

Prognostic classifications for patients treated with sorafenib for hepatocellular carcinoma (HCC) facilitate stratification in trials and inform clinical decision making. Recently, 3 different prognostic models (hepatoma arterial-embolization prognosis [HAP] score, sorafenib advanced HCC prognosis [SAP] score, and Prediction Of Survival in Advanced Sorafenib-treated HCC [PROSASH]-II) have been proposed specifically for patients treated with sorafenib. This study aimed to compare the prognostic performance of different scores.

METHODS:

We analyzed a large prospective database gathering data of 552 patients treated with sorafenib from 7 Italian centers. The performance of the HAP, SAP, and PROSASH-II models were compared with those of generic HCC prognostic models (including the Barcelona Clinic for Liver Cancer and Italian Liver Cancer staging systems, albumin-bilirubin grade, and Child-Pugh score) to verify whether they could provide additional information.

RESULTS:

The PROSASH-II model improved discrimination (C-index 0.62) compared with existing prognostic scores (C-index ≤0.59). Its stratification significantly discriminated patients, with a median overall survival of 21.5, 15.3, 9.3, and 6.0 months for risk group 1, 2, 3, and 4, respectively. The HAP and SAP score were also validated but with a poorer performance compared with the PROSASH-II.

DISCUSSION:

Although suboptimal, PROSASH-II is the most effective prognostic classification model among other available scores in a large Italian population of patients treated with sorafenib.

• Authors: Vito Sansone, Francesco Tovoli, Andrea Casadei-Gardini, Giovan Giuseppe Di Costanzo, Giulia Magini, Rodolfo Sacco, Tiziana Pressiani, Franco Trevisani, Margherita Rimini, Raffaella Tortora, Elena Nardi, Luca Ielasi, Fabio Piscaglia, Alessandro Granito
• Journal: Clinical and translational gastroenterology (Clin Transl Gastroenterol) Vol. 12 Issue 1 Pg. e00286 (01 14 2021) ISSN: 2155-384X [Electronic] United States
• PMID: 33443944 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.

Chemical References

• Antineoplastic Agents
• Sorafenib
• Protein-Tyrosine Kinases

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Hepatocellular (classification, drug therapy, pathology)
• Female
• Humans
• Liver Neoplasms (classification, drug therapy, pathology)
• Male
• Middle Aged
• Neoplasm Grading
• Neoplasm Staging
• Prognosis
• Prospective Studies
• Protein-Tyrosine Kinases (antagonists & inhibitors)
• Reproducibility of Results
• Sorafenib (therapeutic use)
• Survival Analysis