The prognostic value of selected indices combination in hepatocellular carcinoma patients treated with sorafenib

Background : Considering a comprehensive approach to the hepatocellular carcinoma (HCC) patient’s assessment, the aim of the study was to identify the clinical significance of selected indices as prognostic factors in HCC patients treated with sorafenib in daily clinical practice. Materials and methods: Out of 122 available HCC patients, 72 treated with sorafenib (800 mg per day) had their data analyzed. To assess nutritional status, liver condition and tumor burden, changes in the following indices were analyzed: body mass index (BMI), international normalized ratio (INR), the systemic inflammatory response index (SIRI), the platelet-to-lymphocyte ratio (PLR), the neutrophil-to-lymphocyte ratio (NLR), the model for end-stage liver disease (MELD), the albumin–bilirubin (ALBI), the prognostic nutritional index (PNI). Survival analyses were performed. Results: Significant differences were observed during treatment in body mass, BMI, monocyte, albumin, aspartate aminotransferase, bilirubin, SIRI, PNI and ALBI. Survival analyses revealed significant differences in progression-free survival (PFS) in median survival for: SIRI, NLR, ALBI, PNI and albumin (p < 0.001). For overall survival (OS), survival analyses revealed significant differences for albumin and PNI (p < 0.05). Cox regression for PFS and OS, adjusted for age, sex and BMI, revealed significant hazard ratios for albumin and for SIRI in PFS only. Conclusions: Albumin remains an important prognostic factor for both PFS and OS in HCC patients; however, new indices can be successfully used in clinical practice as valuable prognostic tools for PFS in patients with HCC treated with sorafenib.