Integrated liver inflammatory score predicts the therapeutic outcome of patients with hepatocellular carcinoma after transarterial chemoembolization

Abstract: Purpose To evaluate the performance of the Integrated Liver Inflammatory Score (ILIS) in predicting survival in hepatocellular carcinoma (HCC) patients who received transarterial chemoembolization (TACE), and to compare ILIS to other prognostic scoring systems and inflammatory indices. Materials and Methods This study included 192 patients with unresectable HCC who underwent TACE from three medical centers. The potential risk factors of patients’ overall survival (OS) were determined by multivariate Cox regression analysis. The predictive performances of ILIS in 1-, 2-, 3-, 4-, and 5-year survivals were evaluated using receiver operating characteristic (ROC) curves. The discriminatory power in the OS of ILIS and the other known scoring systems or inflammatory indices were determined by C-statistic. Results Multivariate regression analysis showed that high ILIS (P=0.047), low lymphocyte count (P=0.034), beyond up-to-seven criteria (P=0.021), and non-responder to the first TACE session (P=0.039) were risk factors for poor prognosis after TACE. The predictive performances of ILIS for 1-, 2-, 3-, 4-, and 5-year survivals were fairly good, with AUCs of 0.627, 0.631, 0.621, 0.577, and 0.681, respectively. ILIS outperformed other standard scoring systems and inflammatory indices in predicting OS, with a C-statistic of 0.625. Conclusion ILIS is a powerful prognostic index for survival of HCC patients after TACE, suggesting that pretreatment ILIS should be considered during the patient evaluation process.