{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:00:37Z","timestamp":1781067637239,"version":"3.54.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Key Research and Development Plan Project of Anhui Province","award":["201904a07020091"],"award-info":[{"award-number":["201904a07020091"]}]},{"name":"Major Project of Scientific Research Plan for Higher Education Institutions of Anhui Province","award":["2022AH040192"],"award-info":[{"award-number":["2022AH040192"]}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["YD9110002016"],"award-info":[{"award-number":["YD9110002016"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to compare the predictive value of Child-Pugh and MELD scores for the survival rate of HCC patients with splenomegaly who received TACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From January 2018 to January 2025, 306 patients with splenomegaly and HCC who underwent TACE treatment at a tertiary hospital were included in the study. Patients were divided into groups A (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f183), B (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f92), and C (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f31) based on the baseline Child-Pugh score. At the same time, patients were divided into low-risk (MELD&amp;lt;10,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f122), intermediate-risk (MELD10-20,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f122), and high-risk (MELD&amp;gt;20,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f62) groups based on the baseline MELD score. Baseline clinical pathological characteristics were collected. The primary endpoint was overall survival (OS) and progression-free survival (PFS). Survival analysis was performed using the Kaplan\u2013Meier method, and the time series test was used to evaluate the comparison between groups. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the two scoring systems for 1-year postoperative survival rate, and the DeLong test was used for comparison.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The comparison analysis of baseline characteristics showed that there were statistically significant differences in age, maximum tumor diameter, proportion of multifocal tumors, spleen length, total bilirubin, albumin, international normalized ratio (INR), creatinine, red blood cell distribution width (RDW), platelet count, and the incidence of ascites and hepatic encephalopathy among different Child-Pugh grades (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Similarly, significant differences were observed in the above parameters among different MELD risk groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Survival analysis indicated that with the increase in Child-Pugh grade, OS and PFS were significantly decreased (log-rank \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f45.332,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f38.775,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Similarly, with the increase in MELD risk category, OS and PFS significantly decreased (log-rank \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f52.114,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f41.889,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The predictive performance analysis indicated that compared with the Child-Pugh score, the MELD score had a significantly larger area under the curve (AUC) for predicting 1-year survival rate (DeLong test Z\u202f=\u202f3.124,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with HCC and splenomegaly, both Child-Pugh and MELD scores can effectively stratify prognosis. However, the MELD score showed superior predictive performance for 1-year survival rate after TACE, which is worthy of more attention in clinical prognosis assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1804646","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:29:50Z","timestamp":1781065790000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Child-Pugh and MELD scores in predicting survival of hepatocellular carcinoma patients with splenomegaly undergoing TACE: a real-world study"],"prefix":"10.3389","volume":"13","author":[{"given":"Lu","family":"Xu","sequence":"first","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Jiang","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yicheng","family":"Ma","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Pan","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Liang","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Du","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haotian","family":"Wu","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiheng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Lu","sequence":"additional","affiliation":[{"name":"Invasive Technology Department, Second Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"100535","DOI":"10.1016\/j.aohep.2021.100535","article-title":"From child-Pugh to MELD score and beyond: taking a walk down memory lane","volume":"27","author":"Ruf","year":"2022","journal-title":"Ann Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1080\/00365521.2020.1788139","article-title":"Child-Pugh, MELD, MELD-Na, and ALBI scores: which liver function models best predicts prognosis for HCC patient with ascites?","volume":"55","author":"Kim","year":"2020","journal-title":"Scand J Gastroenterol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3819","DOI":"10.1111\/bcp.15333","article-title":"Effect of liver cirrhosis on theophylline trough concentrations: a comparative analysis of organ impairment using child-Pugh and MELD scores","volume":"88","author":"Kurata","year":"2022","journal-title":"Br J Clin Pharmacol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"6654","DOI":"10.3390\/jcm11226654","article-title":"Child-Pugh score, MELD score and Glasgow Blatchford score to predict the in-hospital outcome of portal hypertensive patients presenting with upper gastrointestinal bleeding: an experience from tertiary healthcare system","volume":"11","author":"Jamil","year":"2022","journal-title":"J Clin Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/s00268-019-05211-8","article-title":"A new recalibrated four-category child-Pugh score performs better than the original child-Pugh and MELD scores in predicting in-hospital mortality in decompensated alcoholic cirrhotic patients with acute variceal bleeding: a real-world cohort analysis","volume":"44","author":"Krige","year":"2020","journal-title":"World J Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e129","DOI":"10.3346\/jkms.2020.35.e129","article-title":"Differential impact of serum 25-hydroxyvitamin D3 levels on the prognosis of patients with liver cirrhosis according to MELD and child-Pugh scores","volume":"35","author":"Kim","year":"2020","journal-title":"J Korean Med Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e76767","DOI":"10.7759\/cureus.76767","article-title":"Impact of sodium, potassium, and calcium on the child-Pugh and MELD scores in assessing the severity of liver cirrhosis: a two-year cross-sectional study","volume":"17","author":"Pawar","year":"2025","journal-title":"Cureus"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"11176","DOI":"10.3389\/ti.2023.11176","article-title":"Serum levels of adropin improve the predictability of MELD and child-Pugh score in cirrhosis: results of proof-of-concept clinical trial","volume":"36","author":"Kolben","year":"2023","journal-title":"Transpl Int"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"575","DOI":"10.3350\/cmh.2021.0155","article-title":"Sofosbuvir\/velpatasvir plus ribavirin for child-Pugh B and child-Pugh C hepatitis C virus-related cirrhosis","volume":"27","author":"Liu","year":"2021","journal-title":"Clin Mol Hepatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"8165","DOI":"10.3390\/ijms21218165","article-title":"Recent updates of transarterial chemoembolilzation in hepatocellular carcinoma","volume":"21","author":"Chang","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"26","DOI":"10.2147\/JHC.S422300","article-title":"Transarterial chemoembolization for patients with unresectable hepatocellular carcinoma with child-Pugh B7","volume":"10","author":"Jiang","year":"2023","journal-title":"J Hepatocell Carcinoma"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.hbpd.2022.02.007","article-title":"ASARA, a prediction model based on child-Pugh class in hepatocellular carcinoma patients undergoing transarterial chemoembolization","volume":"22","author":"Jia","year":"2023","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.21037\/atm-2020-112","article-title":"Changes in prognostic factors for patients with hepatocellular carcinoma underwent transarterial chemoembolization with the transition of the time: child-Pugh class, albumin-bilirubin grade, and then","volume":"8","author":"Kawaguchi","year":"2020","journal-title":"Ann Transl Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"354","DOI":"10.3390\/jpm13020354","article-title":"Evaluation of pretreatment albumin-bilirubin grade as a better prognostic factor compared to child-Pugh classification in patients with hepatocellular carcinoma receiving Transarterial chemoembolization combined with radiotherapy","volume":"13","author":"Lee","year":"2023","journal-title":"J Pers Med"},{"key":"ref15","first-page":"271","article-title":"Splenomegaly: diagnosis and Management in Adults","volume":"104","author":"Aldulaimi","year":"2021","journal-title":"Am Fam Physician"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"538","DOI":"10.21037\/atm.2020.02.124","article-title":"Comparison of albumin-bilirubin grade versus child-Pugh score in predicting the outcome of transarterial chemoembolization for hepatocellular carcinoma using time-dependent ROC","volume":"8","author":"Zhao","year":"2020","journal-title":"Ann Transl Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"147","DOI":"10.4166\/kjg.2020.75.3.147","article-title":"Risk factors for liver function deterioration after transarterial chemoembolization refractoriness in child-Pugh class a hepatocellular carcinoma patients","volume":"75","author":"Park","year":"2020","journal-title":"Korean J Gastroenterol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"537","DOI":"10.21037\/atm.2020.02.114","article-title":"Comparison between child-Pugh score and albumin-bilirubin grade in patients treated with the combination therapy of transarterial chemoembolization and sorafenib for hepatocellular carcinoma","volume":"8","author":"Wang","year":"2020","journal-title":"Ann Transl Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e27470","DOI":"10.1097\/MD.0000000000027470","article-title":"Resection or ablation versus transarterial therapy for child-Pugh a patients with a single small hepatocellular carcinoma","volume":"100","author":"Suh","year":"2021","journal-title":"Med Baltimore"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1466113","DOI":"10.3389\/fimmu.2024.1466113","article-title":"Efficacy and safety of transarterial chemoembolization plus lenvatinib combined with PD-1 inhibitors versus transarterial chemoembolization plus lenvatinib for unresectable hepatocellular carcinoma: a meta-analysis","volume":"15","author":"Chen","year":"2024","journal-title":"Front Immunol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"302","DOI":"10.21037\/jgo-23-76","article-title":"Drug-eluting bead transarterial chemoembolization could improve the hepatic hemodynamics of patients with unresectable hepatocellular carcinoma: a retrospective cohort study","volume":"14","author":"Wang","year":"2023","journal-title":"J Gastrointest Oncol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jceh.2017.05.012","article-title":"Role of Indocyanine green in predicting post-Transarterial chemoembolization liver failure in hepatocellular carcinoma","volume":"8","author":"Shalimar","year":"2018","journal-title":"J Clin Exp Hepatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1007\/s00432-020-03135-8","article-title":"Applicability of scoring systems predicting outcome of transarterial chemoembolization for hepatocellular carcinoma","volume":"146","author":"Vogeler","year":"2020","journal-title":"J Cancer Res Clin Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1080\/09674845.2018.1494769","article-title":"Monocyte\/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization","volume":"75","author":"Elalfy","year":"2018","journal-title":"Br J Biomed Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1804646\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:29:51Z","timestamp":1781065791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1804646\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":24,"alternative-id":["10.3389\/fmed.2026.1804646"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1804646","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"article-number":"1804646"}}