Validation of the CRAFITY score for predicting prognosis in patients with hepatocellular carcinoma undergoing transarterial chemoembolization combined with systemic therapy

Q3 Medicine Journal of Interventional Medicine Pub Date : 2025-12-01 DOI:10.1016/j.jimed.2023.12.004

Haifeng Zhou , Jianwu Ren , Feida Wu , Wei Yang , Di Zhu, Yuguan Xie, Qi Shi, Zhongling Pei, Yan Shen, Lingling Wu, Sheng Liu, Haibin Shi, Weizhong Zhou

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Abstract

Background

The CRAFITY score can predict survival and radiological response to systemic front-line treatment in patient with hepatocellular carcinoma (HCC).

Aims

In this study, we aimed to externally validate the CRAFITY score and compare it with other simple prognostic models in patients with unresectable HCC who underwent transarterial chemoembolization (TACE) combined with systemic therapies.

Methods

Patients with unresectable HCC who underwent TACE combined with tyrosine kinase inhibitors (TKIs), with or without immune checkpoint inhibitors (ICIs), were retrospectively analyzed to determine whether the CRAFITY score can predict overall survival (OS) through multivariate analysis and Kaplan‒Meier curves. Prediction of 3- and 6-month objective response rates (ORRs) was validated by the area under the curve (AUC).

Results

Among 147 patients with unresectable HCC, 113 received TACE + TKI and 34 received TACE + TKI + ICI. The CRAFITY score was identified as an independent predictor for OS (P < 0.001) and showed a good ability to categorize all included patients into low-, moderate-, and high-risk groups (P < 0.001). For predicting the 3- and 6-month ORRs, the CRAFITY score exhibited poor performance, with AUCs of 0.555 and 0.515, respectively.

Conclusion

The CRAFITY score is effective in predicting OS but demonstrates limited accuracy in predicting 3- and 6-month ORRs for patients with unresectable HCC undergoing TACE combined with systemic therapies.

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对接受经动脉化疗栓塞术联合全身治疗的肝细胞癌患者预后预测的 CRAFITY 评分进行验证

CRAFITY评分可以预测肝细胞癌（HCC）患者的生存和对系统性一线治疗的放射学反应。在这项研究中，我们旨在外部验证CRAFITY评分，并将其与其他简单的预后模型进行比较，这些模型适用于接受经动脉化疗栓塞（TACE）联合全身治疗的不可切除HCC患者。方法回顾性分析接受TACE联合酪氨酸激酶抑制剂（TKIs），联合或不联合免疫检查点抑制剂（ICIs）的不可切除HCC患者，通过多因素分析和Kaplan-Meier曲线确定CRAFITY评分是否可以预测总生存期（OS）。通过曲线下面积（AUC）验证3个月和6个月客观缓解率（orr）的预测。结果147例不可切除HCC患者中，TACE + TKI 113例，TACE + TKI + ICI 34例。CRAFITY评分被确定为OS的独立预测因子（P < 0.001），并显示出将所有纳入的患者分为低、中、高风险组的良好能力（P < 0.001）。对于预测3个月和6个月的orr， CRAFITY评分表现不佳，auc分别为0.555和0.515。结论CRAFITY评分可有效预测OS，但在预测不可切除HCC患者接受TACE联合全身治疗的3个月和6个月orr时准确性有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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