Prognostic Value of Liver Function and Tumor Burden Scores in Patients with HCC After Transarterial Radioembolization - Retrospective Single Center Analysis.

BACKGROUND: Transarterial radioembolization (TARE) is an established locoregional therapy for advanced hepatocellular carcinoma (HCC). Prognosis depends on both tumor progression and hepatic function. Despite multiple scoring systems, predicting therapeutic benefit remains challenging. MATERIALS AND METHODS: This study evaluated the prognostic performance of established scores (BCLC, HAP, CLIP, OKUDA, ALBI, MELD, and Child-Pugh) for survival after TARE in 86 patients with HCC and liver cirrhosis. Predictive accuracy for 3-, 6-, and 12-month survival was assessed using ROC curve analyses. RESULTS: The median age was 67 years, and the predominant etiologies were alcohol-related and metabolic dysfunction-associated steatotic liver disease. Only ALBI and OKUDA were significantly associated with overall survival (HR 3.10; p < 0.001 and HR 5.02; p = 0.018, respectively). ALBI and CLIP showed the highest predictive accuracy for 3-, 6-, and 12-month survival. In multivariablee analysis, ALBI and OKUDA remained independent predictors of 12-month survival (HR 3.70; p = 0.001 and HR 5.01; p = 0.025, respectively). The ALBI score worsened significantly within 12 weeks after TARE (p < 0.001). CONCLUSION: The ALBI score was the strongest predictor of survival following TARE. In contrast, tumor burden showed limited prognostic relevance, underscoring hepatic functional reserve as a key determinant of outcomes after locoregional liver cancer therapy.