Table 6.
Overview of various aspects of the included immunonutritive and immune-based indices.
| Index | Concept and Characteristics | Included Parameters | Pros | Cons | Current Research Status | Future Research Strategies |
|---|---|---|---|---|---|---|
| Immunonutritive Indices | ||||||
| CALLY | - combines inflammation, immune response, and nutritional status markers (aspects of the PNI) - for liver disease, albumin functions as an indicator of liver function |
- CRP - albumin - lymphocyte count |
- novel combination of inflammation, immune response, nutritional status, and liver function markers provides a more holistic assessment | - scarce literature available - in this study, CALLY was not superior to previously established scoring systems |
- designed for a cohort of patients with HCC undergoing resections [19] - only validated in this study for patients with HCC undergoing TACE |
- further validation needed for patients with HCC undergoing TACE - validation for assessing other HCC treatment options - efficacy of CALLY combined with bilirubin - the mathematical calculation may require improvement |
| PNI | - combines immune response and nutritional status markers | - albumin - lymphocyte count |
- combination of immune response and nutritional status markers | - few studies available on patients with HCC undergoing TACE - divergent results regarding the predictive ability of PNI - the mathematical calculation may require improvement |
- designed for patients with gastric cancer [15] - extensively validated for various cancer entities - few studies available for patients with HCC undergoing TACE - divergent results on its predictive ability - PNI combined with ALBI was identified as a novel, feasible stratification system for patients with HCC undergoing TACE |
- further, large-scale validation needed for patients with HCC undergoing TACE - the integration of immunonutrition into existing stratification systems |
| Other Immune-Based Indices | ||||||
| NLR | - captures shifts in the relationships between blood cells, due to immune response effects | - neutrophil count - lymphocyte count |
- simple calculation - well investigated |
- nutritional status not included - divergent results in studies that compared NLR to other immune-based indices |
- designed for the stratification of critically ill patients, and validated in patients with colorectal cancer, in an oncologic context [36] - extensively validated for various cancer entities, including patients with HCC undergoing TACE |
- NLR combined with nutritional status markers - NLR combined with liver function markers - large-scale validation for patients with HCC undergoing TACE - integration into existing stratification tools |
| PLR | - captures shifts in the relationships between blood cells, due to immune response effects | - platelet count - lymphocyte count |
- simple calculation - well investigated |
- nutritional status not included - divergent results in studies that compared PLR to other immune-based indices |
- designed for the stratification of patients with pancreatic cancer [37] - extensively validated for patients with HCC undergoing TACE |
- PLR combined with nutritional status markers - PLR combined with liver function markers - further large-scale validation for patients with HCC undergoing TACE - integration into existing stratification tools |
| SII | - combines inflammation and immune response markers | - lymphocyte count - neutrophil count - platelet count |
- extensively validated for patients with HCC | - nutritional status not included - literature is scarce for patients undergoing TACE |
- designed for the stratification of patients with HCC undergoing resections [38] - extensively validated for various cancer entities - few studies on the role of the SII in patients undergoing TACE |
- SII combined with nutritional status markers - SII combined with liver function markers - further large-scale validation for patients with HCC undergoing TACE - integration into existing stratification tools |
| ILIS | - combines inflammation, liver function, and tumor markers - specifically developed for patients with HCC |
- albumin - bilirubin - alkaline phosphatase - neutrophil count |
- index is specific for HCC - includes tumor and liver function markers |
- complex calculation - scarce literature for patients with HCC, particularly for patients undergoing TACE |
- specifically designed for patients with HCC [27] - only one external validation study available |
- large-scale validation is mandatory - integration into existing stratification tools |