The CRP level and STATE score predict survival in cirrhotic patients with hepatocellular carcinoma treated by transarterial embolization

Abstract Background Prognostic biomarkers are needed in a heterogeneous population of patients with intermediate hepatocellular carcinoma (HCC) treated by transarterial (chemo)embolization. We aimed to validate the prognostic value of serum CRP levels and the STATE score, combining CRP, albumin and tumor burden. Methods All cirrhotic patients with HCC treated by a first transarterial (chemo)embolization (2007–2013) in our institution were included. Overall survival was assessed using the Kaplan–Meier method, log rank, univariate and multivariate Cox analyses. Results Among 157 patients included, 87% were men, 86% had Child Pugh A. Etiologies of liver disease included alcohol (57%), hepatitis C (32%), hepatitis B (11%) and/or metabolic syndrome (32%); 89% of patients were classified BCLC B. 33% of the patients had a CRP >1 mg/dl and 33% a STATE score conferring poor prognosis ( 1 mg/dl (20 vs. 8 months, P  = 0.00186). Median overall survival was 6.73 months for patients with a STATE score P  = 0.0002). In multivariate analysis, a STATE score P  = 0.0031). Conclusion In cirrhotic patients with HCC who underwent transarterial treatment, serum CRP level and STATE score at baseline can predict overall survival.