Diaz–Beveridge R, et al. – Experts determined prognostic factors in subjects with advanced hepatocellular carcinoma (aHCC) treated with 1st–line sorafenib and developed a new prognostic score to guide management. In this study, followed by early–onset diarrhoea and baseline neutrophil-to-lymphocyte ratio (bNLR), performance status (PS) and Child–Pugh (C–P) score were the main prognostic factors for overall survival (OS). Four risk groups were ascertained for OS depending on these parameters. For patient stratification, this prognostic model could be useful, however, warranted an external validation.

Methods

• They evaluated retrospective review of 145 pts bNLR, overall toxicity, early toxicity rates and overall survival (OS).
• They conducted univariate and multivariate analysis of prognostic factors for OS.
• From the coefficients found in the Cox analysis, the prognostic score was calculated.
• For internal validation, this study employed ROC curves and pseudoR2 index.
• Harrel’s c-index (HCI) and Akaike criteria (AIC) analyzed discrimination ability and calibration.

Results

• Results revealed that the optimal bNLR cut-off for the prediction of OS was 4 (AUC 0.62).
• Performance status (PS) (p < .0001), Child–Pugh (C–P) score (p = 0.005), early-onset diarrhoea (p = 0.006) and BNLR (0.011) were independent prognostic factors in multivariate analysis for OS.
• They found the prognostic score based on these four variables efficient (HCI = 0.659; AIC = 1.180).
• For OS, four risk groups could be identified:
• a very low-risk (median OS = 48.6 months),
• a low-risk (median OS = 11.6 months),
• an intermediate-risk (median OS = 8.3 months) and
• a high-risk group (median OS = 4.4 months).