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Novel model predicted survival rates for HIV-infected HCC patients

A new model predicted survival for patients with hepatocellular carcinoma and HIV better than other methods that only were used to predict survival in HIV-negative patients, according to data presented at the 2014 Conference on Retroviruses and Opportunistic Infections.

Researchers used Cox proportional hazard analysis of 256 HIV-infected patients with hepatocellular carcinoma (HCC) to develop the SHILCA score, which considered multiple baseline variables that each independently predicted survival.

The SHILCA score divided patients into quartiles with increasing scores, defining four stages as A, B, C and D by using seven variables: log₁₀ HIV RNA, performance status, age, tumor size, metastases, albumin and log₁₀ alfa-fetoprotein. Scores were determined by adding the value of each variable multiplied by its beta of the Cox analysis.

With a median score of 2.74 (range, 0.71-5.89), SHILCA predicted a median survival of 12 months.

Patients in SHILCA stage A had an undefined survival rate, as fewer than 50% died, stage B had a median survival rate of 27.8 months, stage C had a median survival rate of 8.2 months and stage D had a median survival rate of 1.5 months (P=1.33*10–30, log rank).

Actuarial survival at 1 year was 92% of stage A patients, 72% of stage B patients, 28% of stage C patients and 7% of stage D patients.

The SHILCA score (Cox chi-square, 137.2; C-statistic, 0.79) was a better predictor of survival than Model to Estimate Survival in Ambulatory Patients with HCC (Cox chi-square, 106.7; C-statistic, 0.76), Cancer of the Liver Italian Program (Cox chi-square, 92.7; C-statistic, 0.73) and Barcelona Clinic Liver Cancer (Cox chi-square, 43.4; C-statistic, 0.68).

“The SHILCA score and staging model that includes HIV viral load, performance status and five other baseline variables can predict survival of HCC in HIV-infected patients with a high degree of accuracy,” the researchers concluded.

For more information:

Merchante N. #702. Predicting Survival of HIV-Infected Patients with Liver Cancer: The SHILCA Score and Staging Model. Presented at 2014 CROI; March 3-6, 2014; Boston.

Disclosure: Nicolas Merchante reports no relevant financial disclosures.