CITRUS-MICAN Score of Hiraoka et al for Identifying a Patient with Hepatocellular Carcinoma for Whom TACE Is Unsuitable

Description

Hiraoka et al reported the CITRUS-MICAN score for identifying a patient with intermediate stage hepatocellular carcinoma who may should not undergo TACE. It was developed after the original MICAN score. The authors are from multiple institutions in Japan.

CITRUS-MICAN is derived from Concept of Indication of TACE Reframing Un-Suitable condition to Manage Intermediate stage liver CANcer.

TACE = trans-arterial chemoembolization

Patient selection: intermediate-grade hepatocellular carcinoma

Parameters:

(1) modified ALBI (m-ALBI) grade of Hiraoka et al (1, 2A, 2B, 3)

(2) Milan criteria

(3) up-to-7 and up-to-11 criteria

Milan Criteria	Up-to-7 Criteria	Up-to-11 Criteria	Tumor Burden
beyond	within		low
beyond	beyond	within	middle
beyond	beyong	beyond	high

Parameter	Finding	Points
modified ALBI	1 or 2a	0
	2b	1
tumor burden	low	0
	middle	1
	high	2

total score =

= SUM(points for both of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 3

• A score >= 2 is unsuitable for TACE and systemic therapy (atezolizumab plus bevaxizumab) is indicated as the initial treatment.

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CITRUS-MICAN Score of Hiraoka et al for Identifying a Patient with Hepatocellular Carcinoma for Whom TACE Is Unsuitable

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