Liver function assessment according to the Albumin–Bilirubin (ALBI) grade in sorafenib-treated patients with advanced hepatocellular carcinoma

Ogasawara, Satoshi; Chiba, Tetsuhiro; Ooka, Yoshihiko; Suzuki, Eiichiro; Kanogawa, Naoya; Motoyama, Tenyu; Tawada, Akinobu; Kanai, Fumihiko; Yokosuka, Osamu

doi:10.1007/s10637-015-0292-9

Cited by 80 publications

(83 citation statements)

References 18 publications

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“…In our previous study, hepatic function worsened with repeated TACE procedures [43] , as determined with the use of the newly proposed ALBI score [44][45][46] . Some reports have noted the usefulness of ALBI grade for patients undergoing sorafenib treatment and for subclassification of BCLC-B HCC [47][48][49] . In fact, ALBI grade 2, but not Child-Pugh class B (score 7), was shown to be an independent risk factor for death by Cox hazard analysis findings in the present study.…”

Section: Resultsmentioning

confidence: 99%

Validation of Newly Proposed Time to Transarterial Chemoembolization Progression in Intermediate-Stage Hepatocellular Carcinoma Cases

Izumoto¹,

Hiraoka²,

Ishimaru

et al. 2017

Oncology

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Background/Aim: Determination of failure of transarterial chemoembolization (TACE) for treatment of Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma (HCC) has become important because of the development of tyrosine kinase inhibitor (TKI) treatment. We evaluated the usefulness and efficacy of the newly proposed time to TACE progression (TTTP). Patients and Methods: From 2006 to 2016, 192 BCLC-B HCC patients [median age 72 years, male/female ratio = 149/43, Child-Pugh score 5/6/7 = 106/56/30, albumin-bilirubin (ALBI) grade 1/2 = 64/128, Kinki criteria B1/B2 = 64/128] were enrolled. TTTP was defined based on a previous report and first imaging performed 3 months after initial TACE had been used to obtain baseline images. The patients were divided into three groups according to TTTP (<5, 5-10, and ≥10 months; group I, II, and III, respectively). We evaluated the relationship between TTTP and overall survival (OS) as well as the prognostic factors for death. Results: The median number of TACE procedures was 4 (interquartile range 3-7). There was a moderate correlation between TTTP and OS (r = 0.527, 95% CI 0.416-0.622, p < 0.001). The median survival for group I (n = 78), II (n = 49), and III (n = 65) was 24.6, 34.7, and 49.5 months, respectively (group I vs. group II, p = 0.023; group I vs. group III, p < 0.001; group II vs. group III, p = 0.037; Holm's method). ALBI grade 2 (HR 1.548, 95% CI 1.004-2.388, p = 0.048), alpha-fetoprotein (>100 ng/mL) (HR 1.540, 95% CI 1.035-2.291, p = 0.033), and TTTP (<5 months) (HR 2.157, 95% CI 1.447-3.215, p < 0.001) were significant prognostic factors for death in multivariate Cox hazard analysis. Conclusion: In patients with reduced TTTP, especially <5 months, it might be difficult to improve prognosis with a repeated TACE procedures. In such cases, reconsideration of the therapeutic strategy might be needed when possible.

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Section: Resultsmentioning

confidence: 99%

Validation of Newly Proposed Time to Transarterial Chemoembolization Progression in Intermediate-Stage Hepatocellular Carcinoma Cases

Izumoto¹,

Hiraoka²,

Ishimaru

et al. 2017

Oncology

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“…The major advantage is that the prognostic value is comparable between the ALBI and Child-Pugh scores, but two subjective variables [i.e., ascites and hepatic encephalopathy [HE]] included in the Child-Pugh score are excluded from the ALBI score. The benefit of the ALBI score for assessing liver function has also been confirmed in advanced HCC patients treated with sorafenib (3). An ALBI score of >− 2.118 may be inappropriate for the use of sorafenib.…”

Section: Introductionmentioning

confidence: 95%

Albumin-bilirubin score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis: A retrospective study

Zou

Qi²,

Zhu³

et al. 2016

Turk J Gastroenterol

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“…Although >5 years have elapsed since the introduction of sorafenib for the treatment of unresectable HCC in daily clinical practice, sorafenib is still regarded as first-line systemic chemotherapeutic agent for HCC (9)(10)(11). In addition, studies on prognostic factors in patients with HCC who underwent sorafenib therapy have mainly focused on tumor-associated factors, liver function, serum biomarkers and combination therapy with sorafenib (12)(13)(14)(15)(16)(17). Substantial skeletal muscle wasting, termed sarcopenia, is an important predictor for survival in patients with solid malignancies (18).…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

et al. 2017

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Abstract. The present study aimed to examine the impact of sarcopenia, defined as low muscle mass on computed tomography (CT), prior to sorafenib therapy on the clinical outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib therapy. In total, 232 patients with unresectable HCC (median age, 72 years) were analyzed, and the extent of sarcopenia was assessed using CT. Cross-sectional areas (cm 2 ) of the skeletal muscles at the third lumbar vertebra level were determined by manual outlining on the CT images. The cross-sectional areas were normalized for height [skeletal rates, progression-free survival (PFS) rates and best treatment response of the sarcopenia group were retrospectively compared with those of the non-sarcopenia group, and the factors associated with OS and PFS were examined. Sarcopenia was observed in 151 patients (65.1%). There were 165 patients with Child-Pugh A and 67 with Child-Pugh B cirrhosis. In the sarcopenia group, the median treatment duration was 66 days, whereas in the non-sarcopenia group it was 103 days (P=0.001). The median OS time was 174 days in the sarcopenia group and 454 days in the non-sarcopenia group (P<0.0001). The median PFS was 77 days in the sarcopenia group and 106 days in the non-sarcopenia group (P=0.0131). Multivariate analysis identified sarcopenia to be an independent predictor of OS (hazard ratio, 0.365; P<0.0001). The objective response rate and disease control rate in the sarcopenia group were significantly lower, compared with those in the non-sarcopenia group (P=0.0146 and P=0.0151, respectively). In conclusion, sarcopenia may be an indicator of poor clinical course in patients with HCC receiving sorafenib. IntroductionHepatocellular carcinoma (HCC) is one of the major causes of cancer-associated mortality worldwide, accounting for 5.7% of all newly diagnosed malignancies (1-5). The annual incidence rates of HCC are the highest in East Asia and Sub-Saharan Africa, where >80% of all known cases develop (1-5). Advances in treatments for HCC during the last few decades markedly improved the prognosis of the disease (1,2,4,5). However, a curative therapy such as surgical resection may be applied to a limited number (<20%) of patients with HCC (5,6). Sorafenib is a multi-kinase inhibitor that suppresses cancer growth and cell proliferation (7,8). Two pivotal randomized phase III studies, namely the Sorafenib HCC Assessment Randomized Protocol study (7)

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Liver function assessment according to the Albumin–Bilirubin (ALBI) grade in sorafenib-treated patients with advanced hepatocellular carcinoma

Abstract: Sorafenib may be indicated for all patients with advanced HCC and ALBI grade 1 and for some with ALBI grade 2. The subdivision of patients with ALBI grade 2 increases the utility of ALBI in identifying patients indicated for sorafenib therapy.

Cited by 80 publications

References 18 publications

Validation of Newly Proposed Time to Transarterial Chemoembolization Progression in Intermediate-Stage Hepatocellular Carcinoma Cases

Validation of Newly Proposed Time to Transarterial Chemoembolization Progression in Intermediate-Stage Hepatocellular Carcinoma Cases

Albumin-bilirubin score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis: A retrospective study

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

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