Authors:	Müller, Lukas Hahn, Felix Auer, Timo Alexander Fehrenbach, Uli Gebauer, Bernhard Haubold, Johannes Zensen, Sebastian Kim, Moon-Sung Eisenblätter, Michel Diallo, Thierno D. Bettinger, Dominik Steinle, Verena Chang, De-Hua Zopfs, David Pinto dos Santos, Daniel Klöckner, Roman
Title:	Tumor burden in patients with hepatocellular carcinoma undergoing transarterial chemoembolization : head-to-head comparison of current scoring systems
Online publication date:	13-Feb-2023
Year of first publication:	2022
Language:	english
Abstract:	Objectives: Recently, 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. Methods: We 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. Results: The 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. Conclusion: In 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.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8669
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Frontiers in oncology 12
Pages or article number:	850454
Publisher:	Frontiers Media
Publisher place:	Lausanne
Issue date:	2022
ISSN:	2234-943X
Publisher DOI:	10.3389/fonc.2022.850454
Appears in collections:	DFG-491381577-G