Fibro-Scan versus Child-Pugh Score for the Assessment of Liver Function and Treatment Outcome in Hepatocellular Carcinoma Patients Treated with Sorafenib or Intervention Therapy

Abstract

Background and study aim: Prognostic evaluation prior to initiating any form of hepatocellular carcinoma (HCC) management is essential. This study aimed to evaluate the effectiveness of liver stiffness (LS) measurement and Child-Pugh score in predicting outcomes in cirrhosis-related hepatocellular carcinoma patients undergoing sorafenib treatment or other interventional therapy. Patients and Methods: In total, 100 patients with cirrhosis-related advanced HCC were included in this study. The Child Pugh-score and LS measurements were performed before and after therapy. LS measurements were performed by transient elastography (FibroScan). Patients were treated using either microwave ablation, transarterial chemoembolization, or sorafenib according to the multidisciplinary team's decision. Patients were followed up for hepatic insufficiency post-therapy and treatment outcomes. Results: The means of LS measurements before and after therapy were 16.1 ± 4.83 kPa and 15.99 ± 5.93 kPa, respectively. There were no statistically significant differences in LS measurements or fibrosis stages before and after therapy. There was a statistically significant difference when comparing outcomes with fibrosis stages and Child-Pugh scores before and after therapy. The cut-off level for LS measurements before therapy for prediction of post-treatment decompensation was 17.75 kPa, with a sensitivity of 73.3 %, specificity of 65 %, positive predictive value of 76 %, negative predictive value of 62 %, and accuracy of 70%. Conclusion: Liver stiffness measurement can better predict liver decompensation and treatment outcomes in hepatocellular carcinoma patients treated with sorafenib or other interventional non-surgical therapies.