Yu et al developed a predictive index for patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT). The authors are from Sungkyunkwan University in Seoul, Korea.
Patient selection: hepatocellular carcinoma with tumor thrombus in the portal vein
Therapy: radiation therapy
Pre-treatment parameters:
(1) ECOG scale
(2) Child-Pugh class
(3) number of tumors
(4) diameter of the tumor in cm
(5) tumor thrombous in the main portal vein (PV)
(6) complete occlusion of portal blood flow
(7) lymph node metastasis
|
Parameter |
Finding |
Points |
|
ECOG scale |
0 or 1 |
0 |
|
|
2 to 4 |
1 |
|
Child-Pugh class |
no cirrhosis or Class A |
0 |
|
|
Class B or C |
1 |
|
number of tumors |
1 or 2 |
0 |
|
|
3 or more |
1 |
|
diameter of tumor |
< 10 cm |
0 |
|
|
>= 10 cm |
1 |
|
tumor thrombus in main PV |
absent |
0 |
|
|
present |
1 |
|
complete venous occlusion |
absent |
0 |
|
|
present |
1 |
|
lymph node metastasis |
absent |
0 |
|
|
present |
1 |
where:
• How to determine tumor diameter when there are multiple tumors was not specified (largest vs sum of diameters).
PITH =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maxium score: 7
• The higher the score the worse the prognosis.
|
Total Score |
Risk |
Median Survival |
|
0 or 1 |
low |
27 months |
|
2 or 3 |
low-to-intermediate |
11 months |
|
4 or 5 |
intermediate-to-high |
6 months |
|
6 or 7 |
high |
3 months |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
