Low applicability of the ��six-and-twelve score� in hepatocellular carcinoma treated with drug-eluting beads transarterial chemoembolization

Pipa-Muñiz, Maria; Castaño-García, Andrés; Sanmartino, Susana; Mesa, Alicia; Álvarez-Navascués, Carmen; González-Diéguez, M.L.; Cadahía-Rodrigo, Valle; Piscoya-Díaz, Mario Ernesto; Costilla-García, Serafín Marcos; Rodrı́guez, Manuel; Varela, Marı́a

doi:10.17235/reed.2021.7696/2020

Cited by 2 publications

(2 citation statements)

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“…In the original study on the SAT, the score outperformed the BCLC classification and the ALBI score in predictive ability. In external validation studies, the C-Indexes for the SAT ranged between 0.60 and 0.70 (14)(15)(16)(17)(18). However, in all the validation studies, the predictive performance of the SAT was within the same range or somewhat below the performance of the BCLC and ALBI scoring systems (14).…”

Section: Discussionmentioning

confidence: 94%

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Tumor Burden in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Head-to-Head Comparison of Current Scoring Systems

et al. 2022

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ObjectivesRecently, several scoring systems for prognosis prediction based on tumor burden have been promoted for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). This multicenter study aimed to perform the first head-to-head comparison of three scoring systems.MethodsWe retrospectively enrolled 849 treatment-naïve patients with HCC undergoing TACE at six tertiary care centers between 2010 and 2020. The tumor burden score (TBS), the Six-and-Twelve score (SAT), and the Seven-Eleven criteria (SEC) were calculated based on the maximum lesion size and the number of tumor nodes. All scores were compared in univariate and multivariate regression analyses, adjusted for established risk factors.ResultsThe median overall survival (OS) times were 33.0, 18.3, and 12.8 months for patients with low, medium, and high TBS, respectively (p<0.001). The median OS times were 30.0, 16.9, and 10.2 months for patients with low, medium, and high SAT, respectively (p<0.001). The median OS times were 27.0, 16.7, and 10.5 for patients with low, medium, and high SEC, respectively (p<0.001). In a multivariate analysis, only the SAT remained an independent prognostic factor. The C-Indexes were 0.54 for the TBS, 0.59 for the SAT, and 0.58 for the SEC.ConclusionIn a direct head-to-head comparison, the SAT was superior to the TBS and SEC in survival stratification and predictive ability. Therefore, the SAT can be considered when estimating the tumor burden. However, all three scores showed only moderate predictive power. Therefore, tumor burden should only be one component among many in treatment decision making.

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Section: Discussionmentioning

confidence: 94%

“…It sums the number of tumor nodes and tumor size to obtain a readily applicable stratification system. In the original study, the score showed promising performance, but in an external validation, contrary results were found for the prognosis prediction (14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 87%

Tumor Burden in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Head-to-Head Comparison of Current Scoring Systems

et al. 2022

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FAIL-T (AFP, AST, tumor sIze, ALT, and Tumor number): a model to predict intermediate-stage HCC patients who are not good candidates for TACE

et al. 2023

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BackgroundPatients with un-resectable hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) are a diverse group with varying overall survival (OS). Despite the availability of several scoring systems for predicting OS, one of the unsolved problems is identifying patients who might not benefit from TACE. We aim to develop and validate a model for identifying HCC patients who would survive <6 months after their first TACE.MethodsPatients with un-resectable HCC, BCLC stage 0-B, who received TACE as their first and only treatment between 2007 and 2020 were included in this study. Before the first TACE, demographic data, laboratory data, and tumor characteristics were obtained. Eligible patients were randomly allocated in a 2:1 ratio to training and validation sets. The former was used for model development using stepwise multivariate logistic regression, and the model was validated in the latter set.ResultsA total of 317 patients were included in the study (210 for the training set and 107 for the validation set). The baseline characteristics of the two sets were comparable. The final model (FAIL-T) included AFP, AST, tumor sIze, ALT, and Tumor number. The FAIL-T model yielded AUROCs of 0.855 and 0.806 for predicting 6-month mortality after TACE in the training and validation sets, respectively, while the “six-and-twelve” score showed AUROCs of 0.751 (P < 0.001) in the training set and 0.729 (P = 0.099) in the validation sets for the same purpose.ConclusionThe final model is useful for predicting 6-month mortality in naive HCC patients undergoing TACE. HCC patients with high FAIL-T scores may not benefit from TACE, and other treatment options, if available, should be considered.

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Low applicability of the ��six-and-twelve score� in hepatocellular carcinoma treated with drug-eluting beads transarterial chemoembolization

Abstract: applicability of the ''six-and-twelve score" in hepatocellular carcinoma treated with drug-eluting beads transarterial chemoembolization. Rev Esp Enferm Dig 2021.

Cited by 2 publications

References 21 publications

Tumor Burden in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Head-to-Head Comparison of Current Scoring Systems

Tumor Burden in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Head-to-Head Comparison of Current Scoring Systems

FAIL-T (AFP, AST, tumor sIze, ALT, and Tumor number): a model to predict intermediate-stage HCC patients who are not good candidates for TACE

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