IDDF2021-ABS-0071 Tumor burden score as a new prognostic marker for patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Background Tumor size and numbers are major determinants of tumor burden in hepatocellular carcinoma (HCC). Patients with HCC undergoing transarterial chemoembolization (TACE) have variables outcomes due to heterogeneity of tumor burden. Recently, tumor burden score (TBS) was proposed to evaluate the extent of tumor involvement. However, the prognostic accuracy of TBS has not been evaluated in HCC. This study aimed to assess its prognostic role in HCC patients undergoing TACE. Methods A total of 935 treatment-naive HCC patients receiving TACE were retrospectively analyzed. Multivariate Cox proportional hazard model was used to determine independent prognostic predictors.TBS was defined as the distance from the origin of the Cartesian plane and the comparison of two variables: maximum tumor size (X-axis) and number of tumors (Y-axis) so that TBS2=(maximum tumor diameter)2+ (number of tumors)2. Patients have divided accordingly into three groups:high TBS (over 13.74), medium TBS (3.36-13.74),and low TBS (less than 3.36). Results TBS tended to increase with the increasing size and number of tumors in this study (IDDF2021-ABS-0071 Figure 1. The association of TBS with tumor diameter and numbers).The Cox model showed that serum creatinine ≥1.2mg/dl (hazard ratio(HR):1.296,95% confidence interval(CI):1.077-1.559,p=0.006), serum α-fetoprotein≥400ng/dl(HR:2.245,95%CI:1.905-2.465, p Conclusions TBS is a feasible new prognostic surrogate marker of tumor burden in HCC and can well discriminate survival in patients undergoing TACE across different baseline characteristics.