Evaluation of the Prognostic Importance of Gustave Roussy Immune Score in Hepatocellular Cancer Etiological Subtypes

Öz

Objective: The prognostic efficiencies of GRIm and HCC-GRIm scores in HCC have been determined in previous studies. However, there is no study evaluating them according to etiological subtypes in the literature yet. The aim of this study was to investigate the prognostic efficacy of GRIm (Gustave Roussy immune score) and HCC-GRIm score in HCC etiological subgroups. Methodology: The study was conducted on patients aged 18 years and older with unresectable/metastatic hepatocellular cancer (HCC) diagnosed between 2017 and 2023. GRIm and HCC-GRIm scores was calculated. The prognostic efficiencies of these scores were evaluated. Results: Sixty-seven (54%) of the patients had low GRIm scores, while 68(54.8%) had low HCC-GRIm scores. Median overall survival (OS) was 17.2 months in patients with low-viral GRIm scores, while median OS was 2.1 months in patients with high-viral GRIm scores. Median OS was 12.6 months in patients with low-nonviral GRIm scores. Median OS was 3.3 months in patients with high-nonviral GRIm scores (HR: 2.4(%95 CI 1.3-4.7) p<0.001). Conclusion: We found that GRIm score was prognostic in terms of OS in HCC. GRIm scores were higher in patients with viral etiology. However, when we evaluated the patients with low/high GRIM scores in terms of viral etiology/nonviral etiology, there was no significant difference in OS. We believe that the GRIm score may help clinicians in terms of prognosis in a difficult-to-manage disease such as HCC. Larger-scale studies investigating prognosis and treatment efficacies in etiological subtypes of HCC are needed.

Anahtar Kelimeler

• HCC-GRIm score
• GRIm score
• HCC
• HCC etiology
• HCC prognostic score

Hepatoselüler Kanser Etiyolojik Subtiplerinde Gustave Roussy İmmün Skorunun Prognostik Öneminin Değerlendirilmesi

Öz

Amaç: HCC'de GRIm ve HCC-GRIm skorlarının prognostik etkinlikleri çalışmalarla belirlenmiştir. Ancak literatürde henüz etiyolojik alt tiplere göre değerlendiren bir çalışma bulunmamaktadır. Bu çalışmanın amacı, HCC etiyolojik alt gruplarında GRIm (Gustave Roussy immün skoru) ve HCC-GRIm skorunun prognostik etkinliğini araştırmaktır. Metodoloji: Çalışmaya, 2017-2023 yılları arasında tanı almış, rezeke edilemeyen/metastatik hepatoselüler kanserli (HCC) 18 yaş ve üzeri hastaları dahil edilmiştir. Hastaların tanı anındaki GRIm ve HCC-GRIm skorları hesaplanmış ve bu skorların prognostik etkinlikleri değerlendirilmiştir. Sonuçlar: Hastaların 67'sinde (%54) düşük GRIm skoru, 68'inde (%54,8) ise düşük HCC-GRIm skoru saptandı. Düşük GRIm skorlu viral etyolojili hastalarda ortanca genel sağkalım (OS) 17,2 ay iken, yüksek GRIm skorlu viral etyolojili hastalarda ortanca OS 2,1 ay olarak bulundu. Düşük GRIm skorlu nonviral etyolojili hastalarda ortanca OS 12,6 ay olarak bulundu. Yüksek GRIm skorlu nonviral hastalarda ortanca OS 3,3 ay olarak bulundu (HR: 2,4 (%95 CI 1,3-4,7) p<0,001). Sonuç: HCC'de GRIm skorunun OS açısından prognostik olduğunu bulduk. Viral etiyolojili hastalarda GRIm skorları daha yüksekti. Ancak düşük/yüksek GRIM skorlu hastaları viral etyoloji/viral olmayan etyoloji açısından değerlendirdiğimizde OS'de anlamlı bir fark bulunamadı. GRIm skorunun HCC gibi yönetimi zor bir hastalıkta prognoz açısından klinisyenlere yardımcı olabileceğine inanıyoruz. HCC’nin etiyolojik alt tiplerinde prognoz ve tedavi etkinliğini araştıran daha geniş ölçekli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• HCC-Grım skoru
• GRIm skoru
• HCC
• HCC etyolojisi
• HCC prognostik skor

Kaynakça

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