Labeur TA, Berhane S, Edeline J, et al. - In this investigation, researchers validated the ‘Prediction Of Survival in Advanced Sorafenib-treated HCC’ (PROSASH) model in hepatocellular carcinoma (HCC) patients treated with sorafenib in daily clinical practice and improved the PROSASH based on patients treated in clinical practice. According to the PROSASH model, patients treated with sorafenib for HCC at 5 tertiary European centres were retrospectively staged. The optimized PROSASH-II model was further developed using 4 center data (training set) and evaluated in an independent dataset. In 445 cases, the PROSASH model was validated, showing clear discrepancies between the four risk groups (OS 16.9-4.6 months). There were a total of 920 individuals (n = 615 in training set, n = 305 in validation set) were available to produce PROSASH-II. Individualized anticipation of survival and risk group stratification using baseline prognostic and predictive parameters with the PROSASH model was validated in HCC patients treated with sorafenib. For fewer and more objective parameters, the refined PROSASH-II model performed at least as good. PROSASH-II can be used in daily practice as a tool for customizing HCC treatment and identifying preplanned subgroups for future studies.