Modified Albumin-Bilirubin Model for Stratifying Survival in Patients with Hepatocellular Carcinoma Receiving Anticancer Therapy

Albumin−bilirubin (ALBI) grade is an objective and reproducible model for evaluating overall survival (OS) in patients with hepatocellular carcinoma (HCC). However, the original ALBI grade was established for patients with Child−Pugh classes A−C. HCC patients with Child−Pugh class C or poor performa...

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Published in:Cancers 2022-10, Vol.14 (20), p.5083
Main Authors: Hsu, Wei-Fan, Hsu, Shih-Chao, Chen, Te-Hong, Lin, Chien-Hung, Lin, Ying-Chun, Chang, Yu-Wei, Wang, Hung-Wei, Liao, Yu-Min, Lai, Hsueh-Chou, Peng, Cheng-Yuan
Format: Article
Language:English
Subjects:
Albumin
Antimitotic agents
Antineoplastic agents
Bilirubin
Cancer therapies
Clinical medicine
Drug therapy
Health aspects
Hepatitis B
Hepatitis C
Hepatocellular carcinoma
Hepatoma
Hospitals
Infections
Laboratories
Liver cancer
Liver diseases
Magnetic resonance imaging
Medical prognosis
Palliative care
Patients
Performance evaluation
Radiation therapy
Regression analysis
Survival
Variables
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Summary:Albumin−bilirubin (ALBI) grade is an objective and reproducible model for evaluating overall survival (OS) in patients with hepatocellular carcinoma (HCC). However, the original ALBI grade was established for patients with Child−Pugh classes A−C. HCC patients with Child−Pugh class C or poor performance status (Barcelona Clinic Liver Cancer (BCLC) stage D) usually receive hospice care. Thus, optimized cutoffs for the ALBI grade for stratifying OS in HCC patients receiving anticancer therapy are pertinent for accurate prognostication. This study retrospectively enrolled 2116 patients with BCLC stages A−C HCC after the exclusion of those ineligible for receiving anticancer therapy. The modified ALBI (mALBI) grades were: an ALBI score ≤−3.02 for mALBI grade 1, an ALBI score >−3.02 to ≤−2.08 for mALBI grade 2, and an ALBI score >−2.08 for mALBI grade 3. The original ALBI and mALBI grades were independent predictors of OS in all the enrolled patients and those receiving transarterial chemoembolization. In patients receiving curative therapy (radiofrequency ablation and surgical resection), the mALBI grade (grade 2 vs. 1 and grade 3 vs. 2) was an independent predictor of OS. Original ALBI grade 2 vs. 1 was an independent predictor of OS but not ALBI grade 3 vs. 2. The mALBI model can differentiate between patients with early, intermediate, or advanced HCC who received anticancer therapy into three prognostic groups. External validation of the proposed mALBI grade is warranted.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14205083