A Model to Estimate Survival in Ambulatory Patients with Hepatocellular Carcinoma (MESIAH)
The MESIAH score, developed by Yang et al. in 2012, is a valuable prognostic tool for estimating survival in ambulatory HCC patients. It was derived from a cohort of 477 patients treated at the Mayo Clinic and validated in 904 patients from a Korean institution. The score is based on independent predictors for survival, such as age, MELD score, serum albumin level, tumor size, tumor number, vascular invasion, and extrahepatic metastasis. Its prognostic value was confirmed in the validation cohort, demonstrating superior accuracy compared to other staging systems like CLIP and JIS. The MESIAH score’s stability across different underlying liver diseases and treatment modalities further supports its reliability.
| MESIAH SCORE = | |
|---|---|
| 0.232 * (Age in Decades) | |
| + 0.099 * (MELD) | |
| - 0.391 * (Albumin) | |
| + 0.290 * (Tumor size) | Size of the largest nodule: 1=<=1cm, 2=1-2 cm, 3=2-3 cm, 4=3-5 cm, 5=5-10 cm, 6=10-15 cm, 7=15-20 cm, 8=>20 cm |
| + 0.153 * (Tumor number) | Number of nodules: 1=1, 2=2, 3=3, 4=4, 5=5 or greater |
| + 1.122 * (Vascular invasion) | 0 = Absent 1 = Present |
| + 1.130 * (Metastasis) | 0 = Absent 1 = Present |
| + 0.082 * (AFP) | AFP capped at 10,000 units |
| +1 |