Effectiveness of the albumin-bilirubin score as a prognostic factor for early recurrence after curative hepatic resection for hepatocellular carcinoma

Abstract

Backgrounds/AimsThe albumin-bilirubin (ALBI) score has been validated as a predictor of disease-free survival and overall survival in hepatocellular carcinoma (HCC). The purpose of this study was to assess the ALBI score as a risk factor for early recurrence (ER) after curative liver resection in HCC.MethodsPatients who underwent liver resection with curative intent for HCC without previous treatment between January 2004 and December 2014 were included in this retrospective study. The utility of the ALBI score in predicting ER and late recurrence (LR) was evaluated.ResultsA total of 465 HCC patients were enrolled; multivariate analysis identified ALBI grade ≥2 (p=0.003) as a risk factor for ER, in addition to hepatitis B virus surface antigen (HBsAg)-positive status (p<0.001), tumor size ≥3.5cm (p≤0.001), lymph-vascular invasion (p=0.001), and the presence of satellite lesions (p=0.009). In subgroup analysis for ALBI grade 1, Model for End-stage Liver Disease score >9 (p=0.046), HBsAg positive status (p=0.004), tumor size ≥3.5 cm (p<0.001), lymph-vascular invasion (p=0.001), presence of satellite lesions (p=0.002), and poor tumor differentiation (p=0.007) were independent risk factors for ER; however, in subgroup analysis for ALBI grade 2, no significant associations with ER were found. Kaplan-Meier curve analysis showed that long-term survival in HCC with ER was significantly shorter than in patients with LR.ConclusionsThe ALBI score was a preoperative risk factor for ER and may be useful in determining appropriate management according to liver function when recurrence develops.

Prognosis after Curative Resection of Single Hepatocellular Carcinoma with A Focus on LI-RADS Targetoid Appearance on Preoperative Gadoxetic Acid-Enhanced MRI

“…The ALBI grade has been validated as a prognostic factor for OS in HCC [34]. Several studies have also reported that the ALBI grade is a feasible predictive marker for tumor recurrence in post-resection HCC [35,36]. Consistent with previous studies, ALBI grade 2 was an independent predictor of RFS in our study.…”

ALBI grade: Evidence for an improved model for liver functional estimation in patients with hepatocellular carcinoma

“… Lee et al. 24 Retrospective 465 Resection Preoperative ALBI grade, but not postoperative ALBI, was an independent risk factor for early recurrence (<1 year). ALBI grade was not found to be associated with late recurrence (>1 year).…”

“…Both preoperative and postoperative ALBI grades were found to be independently associated with recurrence after surgery. [24] , [25] , [26] , [27] Two retrospective studies from Taiwan have demonstrated a more effective role of postoperative than preoperative ALBI grade in predicting late-recurrences and long-term prognosis, even years after surgery. 28 , 29 Moreover, changes in ALBI grade after hepatectomy were found to be independently associated with inferior OS and recurrence-free survival (RFS).…”

Predictive factors for hepatocellular carcinoma recurrence after curative treatments

“…Among other circulating markers or composite scores, the albuminbilirubin (ALBI) score has been validated as a predictor of survival in HCC [79] . Recently, an Asiatic study [80] evaluated the role of ALBI in predicting early recurrence. It was found that an ALBI grade ≥ 2 (P = 0.003) in addition to HBV surface antigen (HBsAg)-positive status (P < 0.001), tumor size ≥ 3.5 cm (P ≤ 0.001), lympho-vascular invasion (P = 0.001), and the presence of satellite lesions (P = 0.009) were the only predictors of early HCC recurrence on multivariate analysis.…”