HAP Score

Hepatoma arterial-embolisation (HAP) Score

HAP Score is a simple score which stratifies, patient with with HCC, who will receive their first TACE. It has 4 prognostic factors

Liver related variables – albumin and bilirubin

Tumor related variables- AFP (alpha-fetoprotein), and tumor size

Patients are then categorizes into low-, intermediate-, high-, and very high-risk groups with average survival of 27.6, 18.5, 9.0, and 3.6 months respectively.¹

Prognostic Factors	Points

Prognostic Factors	Points
Albumin < 36 g/dL	1
AFP > 400 ng/ml	1
Bilirubin > 17 µmol/L	1
Maximum Tumor Diameter > 7 cm	1

HAP Classification	Points
HAP A	0
HAP B	1
HAP C	2
HAP D	> 2

Patients with a HAP score of C or D were classified into poor prognosis groups. These groups were unlikely to derive significant benefits from transarterial chemoembolization (TACE) and may instead benefit more from systemic therapy or supportive care.¹

References

Kadalayil L, Benini R, Pallan L, O’beirne J, Marelli L, Yu D, Hackshaw A, Fox R, Johnson P, Burroughs AK, Palmer DH. A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer. Annals of oncology. 2013 Oct 1;24(10):2565-70.
Karademir S. Staging of hepatocellular carcinoma. Hepatoma Res. 2018;4:58.
Kinoshita, Akiyoshi et al. “Staging systems for hepatocellular carcinoma: Current status and future perspectives.” World journal of hepatology vol. 7,3 (2015): 406-24. doi:10.4254/wjh.v7.i3.406
Subramaniam, Somasundaram et al. “A review of hepatocellular carcinoma (HCC) staging systems.” Chinese clinical oncology vol. 2,4 (2013): 33. doi:10.3978/j.issn.2304-3865.2013.07.05