Background: Sorafenib is the standard treatment for patients with hepatocellular carcinoma (HCC) with advanced stage disease. Prognostic classifications for patients treated with sorafenib facilitate stratification in trials and inform clinical decision making. An accurate prediction model is important to ascertain the prognosis of HCC patients treated with sorafenib. 

Aim of the study: Our study was run to predict the outcome of HCC patients treated with sorafenib using ACLR and HALP scores. 

Subjects and methods: This Observational Retrospective Cohort Study was conducted on 110 Patients with HCC patients from January 2015 to December 2022 at Medical Oncology Department, Faculty of Medicine, Zagazig University. 

Results: HALP and ACLR score were significantly associated with treatment outcome among HCC patients treated with sorafenib. HALP achieved significant level as a predictor for treatment outcome among HCC patients treated with sorafenib at cut off point of 42.9 with sensitivity of 75.7% and specificity of 86.3%. ACLR achieved significant level as a predictor for treatment outcome among HCC patients treated with sorafenib at cut off point of 75.6 with sensitivity of 78.4% and specificity of 82.2%. High HALP score indicates better prognosis with a cut off of 42.9 (PFS 11m vs. 5mp=0.001 and OS 12.8 months vs. 9.5 months, p=0.022). While low or high ACLR didn't indicate any prognostic significance with a cut of 75.6 (PFS 9 months vs. 6 months for high ACLR p=0.122 and OS 11.9 months vs. 10.25 p=0.66).

Conclusion: HALP score can be used as valid prognostic scores for independently predicting the overall prognosis in HCC patients treated with Sorafenib, having a low HALP score indicates worse prognosis. While, having a high ACLR or low score did not show any significance in predicting the overall prognosis 

Keywords: hepatocellular carcinoma, sorafenib, prognostic significance.