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Digestive Diseases and Sciences

25-09-2024 | Hepatocellular Carcinoma | Original Article

AFP-DIAM Score to Predict Survival in Patients with Hepatocellular Carcinoma Before TACE: A French Multicenter Study

Authors: Estelle Rebillard, Nicolas De Abreu, Benjamin Buchard, Léon Muti, Mathieu Boulin, Bruno Pereira, Benoit Magnin, Armand Abergel

Published in: Digestive Diseases and Sciences

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Abstract

Background

Transarterial chemoembolization (TACE) is recommended as a palliative treatment for patients of the B stage of the Barcelona Clinic Liver Cancer (BCLC) classification.

Aims

To identify clinical, biological, and radiological predictors of survival in patients undergoing TACE and develop a pre-therapeutic prognostic score.

Methods

191 adult cirrhotic patients treated for HCC with TACE at the University Hospital (UH) of Clermont-Ferrand (France) from 2007–2017 were retrospectively included. We investigated the impact of baseline liver function, patient characteristics, and tumor burden on overall survival and developed a prognostic score.

Results

Patients had a median age of 66 years and 126 patients were Child A. The AFP-DIAM score distinguishes two groups with a significant difference in survival time (median OS 28.3 months in patients with a score = 0 versus 17.7 months in patients with a score > 0). AFP-DIAM was validated on an external cohort, is well calibrated, and has the best discrimination capacity (C-index) as compared to NIACE, HAP, STATE, and SIX TO TWELVE. AFP-DIAM and SIX TO TWELVE are the more easy-to-use scores. When AFP-DIAM and the SIX TO TWELVE scores were tested in the same statistical model, results confirmed a better AFP-DIAM performance.

Conclusions

The AFP-DIAM is an easy-to-use score which allows to distinguish two groups with different prognosis before the first TACE session. Its use could provide further support to BCLC system to guide the therapeutic strategy of patients with HCC.

Graphical Abstract

An easy-to-use score allows to distinguish two groups with a different median survival. Patient with a high score could receive immunotherapy as first-line treatment.
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Metadata
Title
AFP-DIAM Score to Predict Survival in Patients with Hepatocellular Carcinoma Before TACE: A French Multicenter Study
Authors
Estelle Rebillard
Nicolas De Abreu
Benjamin Buchard
Léon Muti
Mathieu Boulin
Bruno Pereira
Benoit Magnin
Armand Abergel
Publication date
25-09-2024
Publisher
Springer US
Published in
Digestive Diseases and Sciences
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-024-08639-8

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