Prognostic Importance of Combined Use of MELD Scores and SII in Hepatic Visceral Crisis in Patients with Solid Tumours.

OBJECTIVE To determine the sensitivity of combining the model for end-stage liver disease (MELD) scoring with new inflammatory indexes in determining the priority for liver transplantation and demonstrating its potential usability in solid tumour visceral crisis. STUDY DESIGN Descriptive study. Place and Duration of the Study: Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkiye, from June 2017 to June 2022. METHODOLOGY  Patients hospitalised in the medical oncology clinic for hepatic dysfunction were included. The MELD scores of these patients were calculated, and the predictive contribution of the systemic immune-inflammatory index (SII) to prognosis and mortality was evaluated. RESULTS A total of 295 patients (158 (53.6%) men and 137 (46.4%) women) were included. When compared for primary tumour types, colorectal cancers were the most common with 55 (18.6%) cases, followed by breast cancers at 52 (17.6%), pancreatic carcinoma at 50 (16.9%), and stomach cancers at 40 (13.6%) cases. In the survival analyses of all three MELD scores (MELD-Original, MELD-Na, and MELD 3.0) between <20 groups and ≥20 groups, the median Overall Survival (OS) for MELD-Original was 1.44 vs. 0.88 months (p<0.001), for MELD- Na it was 1.64 vs. 0.85 months (p<0.001), and for MELD 3.0 it was 2.16 vs. 1.28 months (p=0.039). In the ROC analysis, the SII parameter cut-off was ≥626.28 for the estimation of mortality, SII sensitivity was 78.7%, and specificity was 100% (p=0.013). CONCLUSION Combined use of MELD and SII scores in patients with solid tumours with hepatic visceral crises will be practical, cost-effective, and easy to access, eliminate gender-based disparities, and contribute to clinical follow-ups with objective data. KEY WORDS Malignant neoplasm, MELD score, MELD-Na, MELD 3.0, SII.