These findings underscore the importance of liver reserve assessment in the management of HCC, highlighting liver failure as an essential reason for morbidity and mortality during the management of HCC unrelated to tumour progression [14] and the enhancement in prediction accuracy when combining CTP with IGF-1 categorised as low and high highlights the value of incorporating multiple biomarkers into liver reserve models, which could significantly improve individualised patient management strategies in a clinical setting. Here, IGF1 is linked to Hepatic failure.