Intermediate-stage hepatocellular carcinoma, for which trans-arterial chemoembolization constitutes the standard of care, is a patient subgroup with significant heterogeneity in clinical outcome.
Sources of variation relate to differences in tumor burden, hepatic reserve, ethnicity and treatment modalities.
Increasing research efforts have been dedicated to minimize the clinical diversity of this patient population and enhance optimal provision of treatment.
Dr Pinato and colleagues from the United Kingdom comprehensively reviewed the diverse prognostic models that have been proposed to refine the prognostic prediction of patients with hepatocellular carcinoma undergoing trans-arterial chemoembolization.
A number of prognostic algorithms have shown potential to address the clinical heterogeneity characterizing patients with intermediate-stage hepatocellular carcinoma.
The team report that these algorithms also facilitate early identification of patients with poor prognostic features in whom alternative treatments or best supportive care might be more appropriate than trans-arterial chemoembolization.
While an improved characterization of intermediate-stage hepatocellular carcinoma is a highly important clinical aim, the team observed that current evidence suggests that novel prognostic algorithms in this patient population may offer potential benefits but non-negligible challenges in the provision of trans-arterial chemoembolization.
Dr Pinato's team comments, "This review summarizes the currently available evidence to facilitate the development of precision oncology in intermediate-stage hepatocellular carcinoma."