984P - Comparative study of scoring systems predicting outcome of transarterial chemoembolization for hepatocellular carcinoma: A nationwide cohort study

Background

Several scoring systems have been proposed to predict the outcome of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). However, the application of the albumin-bilirubin (ALBI) grades to TACE candidates is poorly validated. Evaluation of the applicability of prognostic factors for patients performing TACE is necessary. We aimed to develop new scoring system including ALBI grade.

Methods

2,632 patients with unresectable HCC, child class A/B and ECOG 0-1 performing TACE were included from national cohort of the Korean Central Cancer Registry between 2008 to 2017. Patients were randomly divided into training (n=1,304) and validation cohort (n=1,328). A prognostic model was developed and validated. We compared with previous scoring models.

Results

In entire cohort, the patient’s mean age was 63 years. The patients were hepatitis B virus (57.1%) and child class A (83.2%). The prognostic model of TACE was ‘‘largest tumor diameter+ tumor number, AFP, and ALBI grade”, which consistently outperformed other currently available models in both training and validation datasets. Patients were assigned points according to sum of tumor burden (≤5, 5-10, ≥10), AFP or ALBI grade. Patients were divided into four risk groups based on their TACE-prognostic (TP) scores: A, B, C and D. The median survival for the groups A, B, C and D was 85.9, 67.3, 52.8 and 33.0 months, respectively.

Conclusions

This new TP scoring system may prove a favorable tool to stratify ideal candidates of TACE and predict OS with favorable performance and discrimination. Further external validation is needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.