Survival of patients with advanced hepatocellular carcinoma based on Gustave Roussy immune score and portal vein tumor thrombosis: a single-center, retrospective, non-randomized case-controlled study

The aim of this study was to investigate the survival of patients with advanced hepatocellular carcinoma (HCC) based on Gustave Roussy immune scores (GRIm scores) and portal vein tumor thrombosis (PVTT) who received immune checkpoint inhibitors (ICIs) plus targeted drugs and radiotherapy as first-line treatment. One hundred and forty-three patients with advanced HCC were divided into GRIm score low-risk (GRIm LR) and high-risk (GRIm HR) groups, PVTT and no-PVTT groups according to pre-treatment GRIm scores and PVTT status, respectively, and further subdivided into group A (GRIm LR with no-PVTT), group B (GRIm LR with PVTT), group C (GRIm HR with no-PVTT), and group D (GRIm HR with PVTT). The log-rank (Mantel-Cox) test was used to analyze overall survival (OS) and progression-free survival (PFS). OS and PFS were prolonged by 15.3 and 11.7 months, and 4.3 and 7.6 months, respectively, in the GRIm LR and no-PVTT groups compared to the GRIm HR and PVTT groups. OS and PFS were prolonged by 13.8 and 10.8 months, 21.8 and 16.2 months, and 27.0 and 17.5 months in group A compared to groups B, C, and D, respectively. Group D had the worst OS and PFS at 7.9 and 4.8 months, respectively. The combination of the GRIm score and PVTT status outperformed GRIm scores and PVTT status alone in predicting the survival of patients with HCC and is beneficial for screening the optimal candidates and choosing individualized treatment regimens.