Reply to “Checking the shape of hepatocellular carcinoma: How irregular is irregular?”
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By
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March 21, 2026
Objective:
To address comments on the study establishing the alpha-fetoprotein (AFP) and tumor shape irregularity (ATSI) score for survival prediction in advanced hepatocellular carcinoma (HCC) patients receiving immune checkpoint inhibitors (ICIs).
Key Findings:
- 3D shape irregularity is significantly associated with poor prognosis in HCC.
- The ratio of total tumor volume to total liver volume is an independent predictor of HCC survival.
- The ATSI score offers a practical tool for risk stratification in advanced HCC patients receiving ICIs.
Interpretation:
Both tumor shape and tumor burden are crucial prognostic determinants in HCC, supporting personalized treatment decisions.
Limitations:
- Broader clinical utility of the ATSI score requires confirmation through large-scale prospective studies.
Conclusion:
The ATSI score, derived from routine AFP levels and tumor shape, is a promising tool for risk stratification in advanced HCC patients.
