{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T09:14:51Z","timestamp":1774170891566,"version":"3.50.1"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Optimal scoring system for clinical prognostic factors in patients with unresectable hepatocellular carcinoma (HCC) is currently uncertain. We aimed to develop and externally validate an easy to use tool, particularly for this population, and named it the \u201cunresectable hepatocellular carcinoma prognostic index\u201d (UHPI). We evaluated the data of patients with treatment\u2010naive unresectable HCC who were diagnosed in the training center from 2010 to 2019 (n\u00a0=\u00a0209). A simple prognostic model was developed by assigning points for each covariate in proportion to the beta coefficients in the Cox multivariable model. Predictive performance and distinction ability of the UHPI were further evaluated in an independent European validation cohort (n\u00a0=\u00a0147) and compared with 11 other available models. A simple scoring system was derived, assigning 0.5\/1\/2 scores for six independent covariates including, the Child\u2010Pugh score, Eastern Cooperative Oncology Group performance status, maximum tumor size, vascular invasion or extrahepatic metastasis, lymph node involvement, and alpha\u2010fetoprotein. The UHPI score, ranging from 0 to 6, showed superior performance in prognosis prediction and outperformed 11 other staging or prognostic models, giving the highest homogeneity (c\u2010index, 6\u2010month and 1\u2010year area under the receiver operator characteristic curves), lowest Akaike information criterion, and \u20132 log\u2010likelihood ratio values. The UHPI score allocated well the risk of patients with unresectable HCC for mortality within the first year, using two cut\u2010off values (low\u2010risk, &lt;0.5; intermediate\u2010risk, 0.5\u20102; high\u2010risk, &gt;2). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\u00a0The UHPI score can\u00a0predict prognosis better than other systems in subjects with unresectable HCC and can be used in clinical practice or trials to estimate the 6\u2010month and 1\u2010year survival probabilities for this group.<\/jats:p>","DOI":"10.1002\/hep4.1836","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T09:46:43Z","timestamp":1636451203000},"page":"633-645","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Proposal and Validation of a Novel Scoring System for Hepatocellular Carcinomas Beyond Curability Borders"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0004-2740","authenticated-orcid":false,"given":"Coskun Ozer","family":"Demirtas","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Marmara University School of Medicine,Istanbul,Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7916-5080","authenticated-orcid":false,"given":"Gabrielle","family":"Ricco","sequence":"additional","affiliation":[{"name":"Hepatology Unit,Pisa University Hospital,Pisa,Italy"},{"name":"Biostructure and Bio\u2010imaging Institute of National Research Council of Italy,Naples,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman Cavit","family":"Ozdogan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Marmara University School of Medicine,Istanbul,Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feyyaz","family":"Baltacioglu","sequence":"additional","affiliation":[{"name":"Department of Radiology,Marmara University School of Medicine,Istanbul,Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tunc","family":"Ones","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine,Marmara University School of Medicine,Istanbul,Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perran Fulden","family":"Yumuk","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology,Marmara University School of Medicine,Istanbul,Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ender","family":"Dulundu","sequence":"additional","affiliation":[{"name":"Department of General Surgery,Marmara University School of 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