Retrospective Cohort Study
Copyright ©The Author(s) 2021.
World J Clin Cases. Jun 26, 2021; 9(18): 4559-4572
Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4559
Table 1 Summary of points-based scores
Prognostic systems
Constituents
Risk stratification
Pre-TACE-predictPre-TACE score was calculated according to the following equation = 0.313 × tumor number (0 = single, 1 = multifocal) + 1.252 × log10 tumor size (cm) + 0.230 × baseline log10 AFP (ng/mL) + [-0.0176 × baseline albumin (g/L)] + 0.458 × baseline log10 bilirubin (mcmol/L) + 0.437 × VI (0 = no, 1 = yes) + 0.149 × HBV (0 = no, 1 = yes) + 0.333 × alcoholic (0 = no, 1 = yes) + 0.211 × other etiology if not HCV/HBV/alcoholic (0 = no, 1 = yes)C-1: ≤ 0.94, C-2: > 0.94 to ≤ 1.47, C-3: > 1.47 to ≤ 2.10, C-4: > 2.10
Post-TACE-predictPost-TACE score was calculated according to the following equation 0.207 × tumor number (0 = single, 1 = multifocal) + 1.129 × log10 tumor size (cm) + 0.147 × baseline log10 AFP (ng/mL) + 0.750 × baseline log10 bilirubin (mcmol/L) + 0.447 × VI (0 = no, 1 = yes) + 0.469 × PR (0 = no, 1 = yes) + 1.143 × SD (0 = no, 1 = yes) + 1.354 × PD (0 = no, 1 = yes)C-1: ≤ 1.82, C-2 > 1.82 to ≤ 2.49, C-3: > 2.49 to ≤ 3.37, C-4: > 3.37
6 and 126 and 12 score = tumor size in cm + tumor number ≤ 6/6-12/> 12
NIACETumor nodules ≥ 3, Infiltrative vs Nodular HCC, AFP ≥ 200 ng/mL, Child-Pugh grade A/B, PS ≥ 11 point, 1.5 / 0 point(s), 1.5 points, 0/1.5 points, 1.5 points≤ 1/1.5-3/> 3
ALBIThe ALBI score was calculated according to the following equation = 0.66 × log10 bilirubin - 0.085 × albumin (bilirubin level in mcmol/L and albumin level in g/L)Grade 1: ≤ -2.60, Grade 2: > -2.60 to ≤ -1.39, Grade 3: > -1.39
Table 2 Baseline characteristics of hepatocellular carcinoma patients undergoing transarterial chemoembolization treatment
Demographic variables
Marseille/Nancy cohort, n = 324
Nice cohort, n = 137
Age, median (Q1-Q3), yr68 (62-74)67 (57-75)
Gender n (%)
Male/Female276 (85)/48 (15)126 (92%)/11 (8)
Liver disease n (%)
HCV/HBV/Alcoholism/MS/other129 (40)/14 (4)/122 (38)/42 (13)/17 (5)55 (40)/8 (6)/44 (32)/11 (8)/19 (14)
ECOG (PS-0/1) n (%)324 (100)69 (50)/68 (50)
Cirrhosis n (%)311 (96)118 (86)
Tumor variables
Tumor size, mm, median (Q1-Q3)35 (25-50)46 (25-70)
Nodule (s): n (%) 1/2/3/4/≥ 595 (29)/72 (22)/80 (25)/38 (12)/39 (12)20 (15)/22 (16)/63 (46)/32 (23)/0
Vascular invasion024 (18%)
Laboratory variables
AFP, ng/mL, median (Q1-Q3)16.3 (6.0-120.3)18 (1-600)
PT (%), median (Q1-Q3)76 (64-88)90 (79-100)
Albumin (g/L), median (Q1-Q3)35 (28-38)37 (33-41)
Total bilirubin (mcmol/L), median (Q1-Q3)19.0 (13.7-28.7)11 (8-19)
Platelet count, 109/L, Median (IQR)106 (82-153)-
Child-Pugh grade n (%) A/B7249 (77)/75 (23)126 (92)/11 (8)
ALBI grade 1/ 2/3 n (%)64 (20)/230 (71)/30 (9)52 (38)/79 (58/6 (4)
BCLC stage A/B/C n (%)145 (45)/179 (55)/00/58 (42)/79 (58)
“6 and 12” score allocation n (%)
≤ 6/6-12/> 12154 (48)/163 (50)/7 (2)51 (37)/73 (53)/13 (10)
NIACE score allocation n (%)
≤ 1/1.5-3/> 3168 (52/134 (41)/22 (7)41 (30)/72 (52)/24 (18)
1Pre-TACE allocation n (%)
C-1/C-2/C-3/C-447 (15)/144 (44/109 (34)/23 (7)32 (23)/35 (26)/47 (34)/23 (17)
TACE session, mean (SD)2.7 ± 1.84.0 ± 2.3
Radiological response (after first TACE)
CR/PR/SD2/PD n (%)176 (54)/67 (21)/15 (5)/66 (20)34 (25)/88 (64)/6 (4)/9 (7)
Table 3 Kaplan-Meier survival analysis according to scores and other systems in cohort 1 (n = 324)
Scoring/Staging systems
OS (95%CI), mo
P value (log-rank)
Sidak1
Hazard ratio (95%CI)
P value
2Pre-TACE-predict< 0.0001
Category 1 (n = 47)38 (30-68)RefRef
Category 2 (n = 144)32 (28-36)0.97071.45 (0.96-2.19)0.0769
Category 3 (n = 109)18 (16-21)< 0.00012.99 (1.97-4.54)< 0.0001
Category 4 (n = 23)11 (8-15)< 0.00014.87 (2.81-8.47)< 0.0001
2Post-TACE-Predict< 0.0001
Category 1 (n = 74)44 (35-66)RefRef
Category 2 (n = 125)32 (25-35)0.07251.94 (1.35-2.78)0.0003
Category 3 (n = 80)19 (16-24)< 0.00014.33 (2.92-6.41)< 0.0001
Category 4 (n = 44)12 (8-13)< 0.000114.0 (8.89-22.15)< 0.0001
“6 and 12” score< 0.0001
Sum ≤ 6 (n = 154)31 (27-35)RefRef
Sum 6-12 (n = 163)20 (17-24)0.00091.55 (1.21-1.99)0.0005
Sum > 12 (n = 7)15 (5-19)< 0.00013.80 (1.76-8.21)0.0007
BCLC staging < 0.0001
A (n = 145)35 (29-38)-Ref
B (n = 179)19 (17-23)-1.88 (1.47-2.41)< 0.0001
NIACE score < 0.0001
≤ 1 (n = 168)35 (28-36)RefRef
1.5-3 (n = 134)20 (16-23)< 0.00011.92 (1.49-2.48)< 0.0001
> 3 (n = 22)11 (5-16)< 0.00016.23 (3.87-10.02)< 0.0001
Child-Pugh class 0.0003
A (n = 249)27 (25-31)-Ref
B (n = 75)21 (15-24)-1.66 (1.26-2.19)0.0003
ALBI grade 0.0029
Grade 1 (n = 64)35 (25-43)RefRef
Grade 2 (n = 230)26 (22-28)0.12281.50 (1.06-2.11)0.0216
Grade 3 (n = 30)16 (12-24)0.00162.30 (1.41-3.75)0.0009
Table 4 Comparison of predictive accuracy for overall survival between pre-/post transarterial chemoembolization-predict and staging/scoring systems in cohort 1 (n = 324)
Scoring/Stage systems
1-yr AUROC
P (vs Ref)
2-yr AUROC
P (vs Ref)
3-yr AUROC
P (vs Ref)
C-index
P (vs Ref)
Pre-TACE-predict0.67(0.60-0.75)Ref0.60(0.56-0.64)Ref0.57(0.53-0.60)Ref0.59(0.56-0.61)Ref
“6 and 12” score0.65(0.56-0.74)0.60400.64(0.58-0.70)0.14250.63(0.57-0.70)0.03470.66(0.58-0.73)0.0806
BCLC staging0.60(0.52-0.67)0.05490.64(0.58-0.69)0.17050.61(0.55-0.67)0.15370.61(0.54-0.68)0.4459
NIACE score0.77(0.69-0.84)0.02540.69(0.63-0.75)0.00100.69(0.63-0.75)< 0.00010.70(0.64-0.77)0.0004
Child-Pugh class0.56(0.49-0.63)0.03990.55(0.51-0.60)0.15740.54(0.49-0.59)0.47840.59(0.55-0.64)0.8075
ALBI grade0.63(0.57-0.69)0.39970.56(0.51-0.61)0.19720.55(0.49-0.61)0.73510.62(0.55-0.68)0.3909
Post-TACE-predict0.81(0.76-0.87)Ref0.73(0.68-0.78)Ref0.73(0.67-0.78)Ref0.74(0.68-0.80)Ref
“6 and 12” score0.65(0.56-0.74)< 0.00010.64(0.58-0.70)0.00110.63(0.57-0.70)0.00290.66(0.58-0.73)0.0145
BCLC staging0.60(0.52-0.67)< 0.00010.64(0.58-0.69)0.00050.61(0.55-0.67)< 0.00010.61(0.54-0.68)0.0002
NIACE score0.77(0.69-0.84)0.16730.69(0.63-0.75)0.12630.69(0.63-0.75)0.19270.70(0.64-0.77)0.2562
Child-Pugh class0.56(0.49-0.63)< 0.00010.55(0.51-0.60)< 0.00010.54(0.49-0.59)< 0.00010.59(0.55-0.64)< 0.0001
ALBI grade0.63(0.57-0.69)< 0.00010.56(0.51-0.61)< 0.00010.55(0.49-0.61)< 0.00010.62(0.55-0.68)0.0051
Table 5 Kaplan-Meier survival analysis according to scores and other systems in cohort 2 (n = 137)
Scoring/Staging systems
OS (95%CI), mo
P value (log-rank)Sidak1
Hazard ratio (95%CI)
P value
Pre-TACE-Predict0.0032
Category 1 (n = 32)26 (21-44)RefRef
Category 2 (n = 35)30 (17-50)0.87860.83 (0.46-1.52)0.5463
Category 3 (n = 47)16 (11-20)0.26111.56 (0.92-2.65)2.6614
Category 4 (n = 23)12 (5-15)0.04182.27 (1.24-4.14)0.0079
Post-TACE-Predict0.0022
Category 1 (n = 36)36 (23-44)RefRef
Category 2 (n = 38)21 (12-30)0.48511.47 (0.83-2.61)0.1843
Category 3 (n = 48)16 (12-24)0.06991.89 (1.10-3.23)0.0203
Category 4 (n = 15)9 (5-15)0.00223.68 (1.79-7.55)0.0004
“6 and 12” score0.8633
Sum ≤ 6 (n = 51)26 (16-36)RefRef
Sum 6-12 (n = 73)18 (15-23)0.83281.12 (0.74-1.70)0.5913
Sum > 12 (n = 13)24 (3-48)0.88671.09 (0.54-2.18)0.8159
BCLC staging0.0234
B (n = 58)29 (18-39)-Ref
C (n = 79)16 (13-21)-1.58 (1.06-2.36)0.0253
NIACE score< 0.0001
≤ 1 (n = 41)29 (21-43)RefRef
1.5-3 (n = 72)22 (16-30)0.54631.38 (0.86-2.19)0.1782
> 3 (n = 24)9 (5-12)< 0.00013.69 (2.09-6.51)< 0.0001
Child-Pugh class< 0.0001
A (n = 126)23 (18-29)-Ref
B (n = 11)9 (6-11)-4.74 (2.34-9.59)< 0.0001
ALBI grade< 0.0001
Grade 1 (n = 51)32 (25-44)RefRef
Grade 2 (n = 77)17 (12-21)0.00741.93 (1.26-2.97)0.0026
Grade 3 (n = 9)9 (1-16)< 0.00016.82 (3.14-14.83)< 0.0001

  • Citation: Adhoute X, Larrey E, Anty R, Chevallier P, Penaranda G, Tran A, Bronowicki JP, Raoul JL, Castellani P, Perrier H, Bayle O, Monnet O, Pol B, Bourliere M. Expected outcomes and patients’ selection before chemoembolization—“Six-and-Twelve or Pre-TACE-Predict” scores may help clinicians: Real-life French cohorts results. World J Clin Cases 2021; 9(18): 4559-4572
  • URL: https://www.wjgnet.com/2307-8960/full/v9/i18/4559.htm
  • DOI: https://dx.doi.org/10.12998/wjcc.v9.i18.4559