
A comprehensive analysis of six subclassification systems (Bolondi, Yamakado, Kinki, Wang, Lee, and Kim criteria) evaluated their efficacy in 171 patients with BCLC B HCC undergoing sorafenib therapy across six Italian centres (2010-2021). Except for Yamakado criteria, all systems significantly correlated with overall survival (OS). Postestimation revealed Bolondi and Wang's criteria as most accurate (C-index 0.586, AIC 1338, BIC 1344; and C-index 0.607, AIC 1337, BIC 1344, respectively). Integration of alpha-fetoprotein (AFP) > 400 ng/mL improved accuracy for both systems (C-index 0.599 and 0.624, respectively). The study affirms the continued predictive validity of intermediate-stage subclassification systems during systemic therapy.
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