The munich-transarterial chemoembolisation score holds superior prognostic capacities compared to TACE-tailored modifications of 9 established staging systems for hepatocellular carcinoma

Mark Op Den Winkel, Dorothea Nagel, Philip Op Den Winkel, Philipp M. Paprottka, Laura Schmidt, Hélène Bourhis, Jörg Trojan, Markus Goeller, Florian P. Reiter, Stephanie Susanne Stecher, Enrico N. De Toni, Alexander L. Gerbes, Frank T. Kolligs

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background/Aims: The recently proposed Munich-transarterial chemoembolisation-score (M-TACE) was tailored to suit hepatocellular Carcinoma (HCC) patients evaluated for TACE. M-TACE outperformed the established HCC-staging-systems and successfully passed external validation. Modifications of staging-systems through the rearrangement of stages or by adding prognostic factors are methods of improving prognostic power. M-TACEs performance compared to scores modified this way should be tested. Methods: Seven well-known HCC staging-systems (including Cancer of the Liver Italian Program-score [CLIP] and Barcelona Clinic liver cancer [BCLC]) and 2 TACE-specific scores (Selection for Transarterial Chemoembolisation Treatment [STATE] and Hepatoma Arterial embolisation Prognostic [HAP]) were rearranged in a cohort of 186 TACE-patients through score-point-analysis and subsequent linking of non-significant adjacent score-points. Additionally, a new score was constructed by combining the top established staging-system in TACE patients (CLIP-TACE) and the prognostic parameter with the highest hazard ratio for death in the TACE-cohort [C-reactive protein (CRP)]. Additionally, the TACE-tailored-scores were applied to an external TACE-cohort (n = 71). -Results: Rearrangement resulted in optimal stratification and monotonicity. CLIP-TACE demonstrated the best prognostic capability of all rearranged scores (c-index 0.668, AIC 1294) and the addition of CRP yielded further prognostic improvement (c-index 0.680, AIC 1289). However, superiority over M-TACE could not be achieved by any of the new scores in the internal and external cohort. Conclusion: M-TACE outperforms TACE-tailored modifications of all relevant HCC-staging-systems. Prospective validation of M-TACE to promote its role as the preferred staging-system for TACE-patients is therefore justified.

Original languageEnglish
Pages (from-to)15-26
Number of pages12
JournalDigestion
Volume100
Issue number1
DOIs
StatePublished - 1 Jul 2019
Externally publishedYes

Keywords

  • Barcelona clinic liver cancer
  • Cancer of the liver Italian programme-score
  • Hepatocellular carcinoma staging systems
  • Hepatoma arterial embolisation prognostic
  • Munich-transarterial chemoembolisation-score
  • Selection for transarterial chemoembolisation treatment

Fingerprint

Dive into the research topics of 'The munich-transarterial chemoembolisation score holds superior prognostic capacities compared to TACE-tailored modifications of 9 established staging systems for hepatocellular carcinoma'. Together they form a unique fingerprint.

Cite this