Usefulness of the MESH score in a European hepatocellular carcinoma cohort

Table 1 Baseline characteristics in European hepatocellular carcinoma cohort (n = 581) n (%)

Patients characteristics	Cohort (n = 581)
Age, yr, mean ± SD	67.4 ± 11.7
Male	475 (82)
Etiology - HCV/HBV/Alcohol/MS/others	209 (36)/41 (7)/215 (37)/87 (15)/29 (5)
Cirrhosis	505 (87)
Child - Pugh stage1 A/B	323 (64)/182 (36)
Maximal tumor diameter, mean ± SD	60.9 ± 39.1
Tumor nodularities (1/2/≥ 3), n (%)	227 (39%)/76 (13%)/278 (48)
Infiltrative tumor	235 (40)
Extrahepatic metastasis	59 (10)
Vascular invasion	213 (37)
Performance status 0/1/2-4	276 (48)/136 (23)/169 (29)
Laboratory values (mean ± SD)
Alkaline phosphatase (IU/L) > 200	112 (19)
PT (%), mean ± SD	78.0 ± 15.8
Albumin (g/L), mean ± SD	34.7 ± 6.1
Aspartate transaminase (IU/L), mean ± SD	68.7 ± 60.7
Alpha-fetoprotein (ng/mL), mean ± SD	5680 ± 31332
Tumor stages
BCLC (A/B/C/D), n (%)	181 (31)/92 (16)/241 (41)/67 (12)
Treatment allocation
Resection or RFA, n (%)	131 (23)
TACE, n (%)	175 (30)
Sorafenib, n (%)	152 (26)
Supportive care, n (%)	123 (21)
Follow-up Time, mo, mean ± SD	18.3 ± 20.3
Deaths, n (%)	413 (71)
Overall Survival, mo, mean ± SD	26.0 ± 1.3

¹Cirrhotic patients. HCV: Hepatitis C virus; HBV: Hepatitis B virus; MS: Metabolic syndrom; PT: Prothrombin time; BCLC: Barcelona Clınic Liver Cancer; RFA: Radiofrequency ablation; TACE: Trans arterial chemoembolization.

Table 2 Comparison of performances of each scoring systems in the entire cohort

Score	Discriminatory ability linear trend test		Homogeneity likelihood ratio test		Akaike Information Criterion	C-index (95%CI)
	LT (χ²)	P value	LR (χ²)	P value
MESH	145.125	< 0.0001	372.4846	< 0.0001	4145.284	0.830
BCLC	137.845	< 0.0001	327.5024	< 0.0001	4194.266	0.806
HKLC	104.966	< 0.0001	387.2755	< 0.0001	4146.493	0.811
CLIP	108.423	< 0.0001	341.3485	< 0.0001	4101.288	0.816
NIACE	144.998	< 0.0001	425.6698	< 0.0001	4092.099	0.853

MESH: Model to estimate survival for HCC; BCLC: Barcelona Clinic Liver Cancer; HKLC: Hong Kong Liver Cancer; CLIP: Cancer of the Liver Italian Program; NIACE: Tumor Nodularity, Infiltrative nature of the tumor, Serum Alpha-fetoprotein level, Child-Pugh stage, Eastern Cooperative Oncology Group Performance Status; LT: Linear trend; LR: Likelihood ratio.

Table 3 Comparison of performances of each scoring systems in patients treated by surgery/radiofrequency ablation

Score	Discriminatory ability linear trend test		Homogeneity likelihood ratio test		Akaike Information Criterion	C-index (95%CI)
	LT (χ²)	P value	LR (χ²)	P value
MESH	21.5588	< 0.0001	23.3342	< 0.0001	346.508	0.719
BCLC	15.5560	< 0.0001	12.4538	0.0020	359.388	0.644
HKLC	5.9647	0.0146	18.9510	0.0020	358.891	0.629
CLIP	9.9391	0.0016	13.1460	0.0003	356.696	0.642
NIACE	19.1701	< 0.0001	23.1937	< 0.0001	346.648	0.672

MESH: Model to estimate survival for HCC; BCLC: Barcelona Clinic Liver Cancer; HKLC: Hong Kong Liver Cancer; CLIP: Cancer of the Liver Italian Program; NIACE: Tumor Nodularity, Infiltrative nature of the tumor, serum Alpha-fetoprotein level, Child-Pugh stage, Eastern Cooperative Oncology Group Performance Status.