ArticleJournal of gastroenterology2025
Alpha-fetoprotein combined with initial tumor shape irregularity in predicting the survival of patients with advanced hepatocellular carcinoma treated with immune-checkpoint inhibitors: a retrospective multi-center cohort study.
Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Large language model and Gd-EOB-DTPA-enhanced MRI-based risk stratification system for postoperative hepatocellular carcinoma: a multicenter study.European radiology · 2026Article
- Checking the shape of hepatocellular carcinoma: how irregular is irregular?Journal of gastroenterology · 2026Article
- Reply to "Checking the shape of hepatocellular carcinoma: How irregular is irregular?"Journal of gastroenterology · 2026Article
- Serum alpha-fetoprotein kinetics as a mechanistic biomarker for rAAV-TK/GCV efficacy in hepatocellular carcinoma.American journal of translational research · 2026Review
- Noninvasive prediction of the clinical benefit of immunotherapy in hepatocellular carcinoma.Journal of gastroenterology · 2025Review
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Abstract
backgroundImmune checkpoint inhibitors (ICIs) are playing a significant role in the treatment of hepatocellular carcinoma (HCC). This study aims to explore the prognostic value of alpha-fetoprotein (AFP) and initial tumor shape irregularity in patients treated with ICIs.
methodsIn this retrospective, multi-center study, 296 HCC patients were randomly divided into the training set and the validation set in a 3:2 ratio. The training set was used to evaluate prognostic factors and to develop an easily applicable ATSI (AFP and Tumor Shape Irregularity) score, which was verified in the validation set.
resultsThe ATSI score was developed from two independent prognostic risk factors: baseline AFP ≥ 400 ng/ml (HR 1.73, 95% CI 1.01-2.96, P = 0.046) and initial tumor shape irregularity (HR 1.94, 95% CI 1.03-3.65, P = 0.041). The median overall survival (OS) was not reached (95% CI 28.20-NA) in patients who met no criteria (0 points), 25.8 months (95% CI 14.17-NA) in patients who met one criterion (1 point), and 17.03 months (95% CI 11.73-23.83) in patients who met two criteria (2 points) (P = 0.001). The median progression-free survival (PFS) was 10.83 months (95% CI 9.27-14.33) for 0 points, 8.03 months (95% CI 6.77-10.57) for 1 point, and 5.03 months (95% CI 3.83-9.67) for 2 points (P < 0.001). The validation set effectively verified these results (median OS, 37.43/24.27/14.03 months for 0/1/2 points, P = 0.028; median PFS, 13.93/8.30/4.90 months for 0/1/2 points, P < 0.001).
conclusionsThe ATSI score can effectively predict prognosis in HCC patients receiving ICIs.
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