Hsu et al developed a group of prognostic scores for patients with hepatocellular carcinoma. The authors are from National Yang-Ming University and Taipei Veterans General Hospital in Taiwan.
Patient selection: adult with hepatocellular carcinoma
Parameters:
(1) total tumor volume (TTV) in cubic cm, based on summation of all tumor nodule volumes
(2) serum AFP concentration in ng/mL
(3) Child-Pugh stage (A, B or C)
(4) vascular invasion
(5) MELD score
Parameter
Finding
Points
total tumor volume
< 50 cubic cm
0
50 to 250
1
251 to 500
2
> 500 cubic cm
3
serum AFP
< 400 ng/mL
0
>= 400 ng/mL
1
Child-Pugh stage
A
0
B
1
C
2
vascular invasion
absent
0
present
1
MELD score
< 10
0
10 to 14
1
>= 15
2
Multiple combinations for these variables were correlated with outcomes.
The model with the best performance was the sum of total tumor volume, Child-Pugh stage and serum AFP concentration.
TTV-CPS-AFP score = TIS score =
= SUM(points for the 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the worse the prognosis.
Score
50% Cumulative Survival
0
88 months
1
65 moths
2
25 months
3
13 months
4
9.6 months
5
3.6 months
6
1.8 months
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