The MELD-Na is an independent short- and long-term prognostic predictor for hepatocellular carcinoma: A prospective survey.

Abstract: Background and aim: Serum sodium has been suggested to incorporate into the model for end-stage liver disease to enhance its prognostic ability for cirrhosis. A mathematical equation based on model for end-stage liver disease and sodium, known as “MELD-Na”, was developed for outcome prediction for cirrhosis. The severity of liver cirrhosis is a key component to predict survival in patients with hepatocellular carcinoma. This study investigated the prognostic role of MELD-Na for hepatocellular carcinoma. Patients and methods: A total of 535 unselected hepatocellular carcinoma patients were prospectively enrolled to evaluate the performance of MELD-Na. Results: The MELD-Na was better than model for end-stage liver disease in predicting 6-month mortality by comparing the area under receiver operating characteristic curve (0.782 vs. 0.761, p =0.101). MELD-Na, but not model for end-stage liver disease, was an independent predictor associated with 6-month mortality in multivariate logistic regression analysis (odds ratio: 1.14, p =0.001). In the survival analysis, MELD-Na also independently predicted mortality, with an additional risk of 4.3% per unit increment of the score (p <0.001). Patients with MELD-Na scores between 10 and 20 and scores >20 had 2.1-fold (p <0.001) and 7.5-fold (p <0.001) risk of mortality, respectively, compared to patients with a score <10 in the Cox proportional hazard model. Conclusion: The MELD-Na score is a feasible and independent prognostic predictor for both short- and long-term outcome predictions in patients with hepatocellular carcinoma. [Copyright &y& Elsevier]