ALBI and P-ALBI grade in Child-Pugh A patients treated with drug eluting embolic chemoembolization for hepatocellular carcinoma

Carling, Ulrik; Røsok, Bård I.; Line, Pål–Dag; Dorenberg, Eric

doi:10.1177/0284185118799519

Cited by 13 publications

(13 citation statements)

References 197 publications

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“…A risk of post hepatectomy liver failure and long-term survival is stratified using the simple score [27]. It has a long-term impact on liver function on curative or locoregional therapy for hepatocellular carcinoma [28,29,30,31]. The present data also aligned with results from a previous study involving 63 Chinese PBC patients proving that a smaller ALBI score predicted improved event-free survival [32].…”

Section: Discussionsupporting

confidence: 80%

Prediction of Transplant-Free Survival through Albumin-Bilirubin Score in Primary Biliary Cholangitis

Fujita

Nomura

Morishita

et al. 2019

JCM

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Albumin–bilirubin (ALBI) grade is defined using the ALBI score, which is calculated based on total serum bilirubin and albumin. This study aimed to evaluate the diagnostic ability of the ALBI score for determining hepatic fibrosis stage and transplant-free survival in primary biliary cholangitis (PBC) patients. A total of 181 Japanese patients with biopsy-proven or serologically diagnosed PBC were enrolled. The pathological stage was assessed using the Scheuer classification. The ALBI score differentiated fibrosis in stage 4 from that of 3 in the biopsy-proven cohort (p < 0.05). With an ALBI score cut-off value of −1.679, the sensitivity and specificity were 100% and 91.1%, respectively, with a likelihood ratio of 12.3 to differentiate stage 4 from stages 1–3. The ALBI score at the beginning of ursodeoxycholic acid (UDCA) prescription correlated with the two prognostic scores calculated after 1-year UDCA treatment. Kaplan–Meier analysis showed that the baseline ALBI score differentiated liver transplant-free survival (p < 0.05). The ALBI score presented a greater hazard ratio for transplant-free survival than aspartate aminotransferase-to-platelet ratio index (APRI) in Cox proportional hazard model. In conclusion, ALBI score indicates pathological stage in Japanese PBC patients and scores before UDCA prescription predict better liver transplant-free survival, which correlated well with the two major prognostic scores. The prognosis-predicting ability of the ALBI score might surpass that of APRI.

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Section: Discussionsupporting

confidence: 80%

Prediction of Transplant-Free Survival through Albumin-Bilirubin Score in Primary Biliary Cholangitis

Fujita

Nomura

Morishita

et al. 2019

JCM

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“…The preoperative ALBI score has a long‐term impact on liver function after curative therapy for HCC . Accumulating evidence indicated that the ALBI score predicted prognosis of patients with HCC who underwent oral chemotherapy using sorafenib, radioembolization, and drug‐eluting embolic chemoembolization . The ALBI score also correlated with recurrence of HCC after curative treatments, surgical resection, or ablative therapy .…”

Section: Discussionmentioning

confidence: 99%

Albumin–bilirubin score indicates liver fibrosis staging and prognosis in patients with chronic hepatitis C

Fujita

Oura

Yoneyama

et al. 2019

Hepatology Research

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Aim Albumin–bilirubin (ALBI) grade was investigated to predict prognosis of patients with cirrhosis. It was defined using the ALBI score calculated based on serum total bilirubin and albumin, which represent liver function. The diagnostic accuracy for liver fibrosis staging in patients with chronic hepatitis using the ALBI score has not been investigated well. This study aimed to evaluate the diagnostic abilities of the ALBI score for liver fibrosis staging in chronic hepatitis and cirrhosis in Japanese patients with hepatitis C virus (HCV) infection. Methods Japanese patients with HCV infection who underwent liver biopsy examinations were enrolled in a retrospective study. Fibrosis staging and activity grading were assessed using the modified METAVIR score. The ALBI score was calculated according to the following equation: Log10 total bilirubin (μmol/L) × 0.66 + albumin (g/L) × (−0.085). Results A total of 382 patients were enrolled in this study. The ALBI score differentiated fibrosis stage 4 from 3 and stage 3 from 2 (P < 0.05). When an ALBI score of −2.125 was adopted as a cut‐off value, the sensitivity and specificity were 73.2% and 87.1%, respectively, with a positive likelihood ratio of 5.67 to differentiate stage 4 from stages 1–3. Kaplan–Meier analysis showed that smaller ALBI scores at baseline correlated with better hepatocellular carcinoma (HCC)‐free and overall survival (P < 0.05). Conclusions The ALBI score indicates liver fibrosis staging in Japanese patients with HCV infection. Furthermore, smaller ALBI scores predict better HCC‐free survival and overall survival. The ALBI score has the potential to expand its application from cirrhosis to chronic hepatitis.

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“…This advantage can be exemplified considering that using mHAP-II, a patient with an HCC of 20 cm and albumin 2.1 mg/dL would have received the same points as a patient with a tumor of 6 cm and 3.5 mg/dL albumin. ALBI and pALBI are 2 scores proposed to overcome the limitations of the CPT score in assessing liver function [13, 14, 23]. In CPT class A, ALBI succeeded in distinguishing 2 prognostic subgroups, ALBI grade 1 and ALBI grade 2, with a 10-month difference in survival.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, Pinato et al [18] validated the prognostic role of the ALBI grade across all BCLC stages. In pALBI, platelet count was added to include a surrogate marker of portal hypertension, and this prognostic model was proposed for CPT-A patients undergoing TACE [23]. However, these 2 scores did not perform very well in our TACE series, and the reason for this poor performance could rely on the fact that most (nearly 80%) of our patients belonged to ALBI grade 2.…”

Section: Discussionmentioning

confidence: 99%

“…Age, blood chemistries, tumor characteristics (tumor size and number, macrovascular invasion, and extrahepatic spread), and Eastern Cooperative Oncology Group performance status (ECOG PS) were evaluated before each TACE procedure. At the same time points, the following prognostic classes were calculated: hepatoma arterial embolization (HAP) [15], modified hepatoma arterial embolization II (mHAP-II) [16], modified hepatoma arterial embolization III (mHAP-III) [17], ALBI [13], platelet-albumin-bilirubin (pALBI) [23], model for end-stage liver disease (MELD) [24], and Child-Turcotte-Pugh (CPT) [25]. Moreover, patients were allocated to the pertinent stages of the following staging systems: BCLC [4], ITA.LI.CA [26], Cancer of the Liver Italian Program (CLIP) [27], MESH [28], Model to Estimate Survival In Ambulatory HCC patients (MESIAH) [29], Japan Integrated Staging system (JIS) [30], and Hong Kong Liver Cancer (HKCL) [31].…”

Section: Methodsmentioning

confidence: 99%

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Time-Varying mHAP-III Is the Most Accurate Predictor of Survival in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

et al. 2021

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Introduction: The prognosis of patients undergoing transarterial chemoembolization (TACE) is extremely variable, and a confounding factor is that TACE is often repeated several times. We retrospectively evaluated the accuracy of different prognostic scores and staging systems in estimating overall survival (OS) in patients with hepatocellular carcinoma (HCC). Methods: An analysis considering prognostic models as time-varying variables was performed, calculating OS from the time of TACE to the time of the subsequent treatment. Total follow-up time for each patient was therefore split into several observation times accounting for each TACE procedure. Values of the likelihood ratio test (LRT) and Akaike information criterion (AIC) were used to compare different systems. Univariable and multivariable analyses were conducted to identify additional factors predictive of OS. We analyzed 1,610 TACE performed in 1,058 patients recorded in the Italian Liver Cancer database from 2008 through 2016. Results: The median OS of the enrolled patients was 41 months. According to LRT χ2 and AIC values based on the time-varying analysis, mHAP-III achieved the best values (41.72 and 4,625.49, respectively, p < 0.0001), indicating the highest predictive performance compared with all other scores (HAP, mHAP-II, ALBI, and pALBI) and staging systems (MELD, ITALICA, CLIP, MESH, MESIAH, JIS, HKLC, and BCLC). In the multivariable Cox proportional hazards model, mHAP-III maintained an independent effect on OS (hazard ratio 1.31, 95% CI: 1.10–1.55, p < 0.0001). Time-varying age, alcoholic etiology, radiologic response to TACE, and performing ablation or surgery after TACE were additional significant variables resulting from the multivariable model. Conclusion: An innovative time-varying analysis revealed that mHAP-III was the most accurate model in predicting OS in patients with HCC undergoing TACE. Other clinical pre- and post-TACE variables were also found to be relevant for this prediction.

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ALBI and P-ALBI grade in Child-Pugh A patients treated with drug eluting embolic chemoembolization for hepatocellular carcinoma

Cited by 13 publications

References 197 publications

Prediction of Transplant-Free Survival through Albumin-Bilirubin Score in Primary Biliary Cholangitis

Prediction of Transplant-Free Survival through Albumin-Bilirubin Score in Primary Biliary Cholangitis

Albumin–bilirubin score indicates liver fibrosis staging and prognosis in patients with chronic hepatitis C

Time-Varying mHAP-III Is the Most Accurate Predictor of Survival in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

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