The relationship between survival and PIV and SIRI score in patients with hepatocellular carcinoma

Introduction and Objective: HCC is the most common primary malignant tumor of the liver and has a high mortality rate. Despite all the research on this topic, HCC remains a malignancy that typically receives a late diagnosis and carries a poor prognosis. Studies on parameters that will guide diagnosis and treatment in HCC and reliably predict survival, especially non-invasive and easily accessible parameters, are still needed. The main purpose of this study is to examine the relationship between PIV and SIRI scores, which are simply calculated from easily accessible hemogram parameters, and survival in HCC. Materials and Methods : The study is retrospective, and the sample includes adult patients who were treated at Akdeniz University Hospital with the ICD code 'C22.0-Hepatocellular Carcinoma' between January 1, 2014 and January 1, 2024. Patients who were under 18 years old at the time of diagnosis, pregnant, diagnosed before 2014, had a concomitant infection at the time of diagnosis, used drugs such as steroids that could affect hemogram count and/or rheumatological-hematological-autoimmune disease, had an additional malignancy, had missing data, or had wrong ICD code were excluded from the trial. Demographic information about the patients, parameters related to the underlying liver illness, tumor stages, treatments received, and laboratory parameters at the time of diagnosis were evaluated. The relationship between these parameters and survival at 3, 6, 12, 24,and 60 months was investigated. Results : The study involved 135 patients. PIV and SIRI scores at diagnosis were significantly greater in patients who died at 3, 6, 12, 24, and 60 months compared to survivors (p < 0.05). When the effectiveness of these scores in predicting death was studied, it was discovered that both the PIV and SIRI scores calculated at diagnosis efficiently predicted mortality at 3, 6, 12, and 24 months, with the SIRI score having a higher efficacy. However, whereas the PIV score was found to be beneficial in predicting 60-month death, the SIRI score did not perform similarly. Conclusion : Inflammation is one of the main steps in tumor pathogenesis. Based on this, studies have shown that inflammatory parameters can be used to predict prognosis in cancer patients. Two of these parameters, the PIV and SIRI scores, have advantages and disadvantages against each other in predicting short- and long-term mortality due to their components. Therefore, the periodic effectiveness of these parameters should be taken into account in clinical decisions. Keywords: Hepatocellular carcinoma, PIV, SIRI, inflammation, survival