Predictive Outcomes Using Child-Turcotte-Pugh and Albumin-Bilirubin Scores in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

Akarapatima, Keerati; Chang, Arunchai; Prateepchaiboon, Tanaporn; Pungpipattrakul, Nuttanit; Songjamrat, Apiradee; Pakdeejit, Songklod; Rattanasupar, Attapon; Piratvisuth, Teerha

doi:10.1007/s12029-021-00743-6

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…In our study, the correlation between the EZ-ALBI and ALBI scores was excellent, with a correlation coe cient of 1.000, which was in line with the studies by Kariyama et al and Ho et al 15,16 The prognostic performance of CTP, MELD, and ALBI scores among patients receiving TACE remains unclear in previous studies. [26][27][28][29] In this study, EZ-ALBI and ALBI scores showed high AUROCs and C-indices, which outperformed other models for anticipating death in this population.…”

Section: Discussionmentioning

confidence: 62%

Validation and Prognostic Value of EZ-ALBI Score in Patients with Intermediate-Stage Hepatocellular Carcinoma Treated with Trans-Arterial Chemoembolization

Ananchuensook

Sriphoosanap

Suksawatamnauy

et al. 2022

Preprint

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BackgroundHeterogeneity of liver function and tumor burden in intermediate-stage hepatocellular carcinoma (HCC) results in different outcomes after transarterial chemoembolization (TACE). Easy albumin-bilirubin (EZ-ALBI), a simplified albumin-bilirubin (ALBI) score, has recently been proposed as a new prognostic score for HCC. This study aimed to validate the EZ-ALBI score and evaluate the impact of dynamic changes in patients with intermediate-stage HCC undergoing TACE.MethodsAll patients with HCC treated with TACE at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between January 2015 and December 2019 were prospectively enrolled. Intermediate-stage HCC was defined as Barcelona Clinic Liver Cancer (BCLC) stage B or unresectable single HCC with size >5 cm in BCLC stage A. EZ-ALBI and ALBI scores were calculated and stratified into three different grades. Overall survival (OS) and prognostic factors were assessed using the Kaplan-Meier curve and Cox proportional hazard model.ResultsAmong 672 patients with HCC treated with TACE, 166 patients with intermediate-stage HCC who met the eligibility criteria were enrolled. The median OS of all patients in the cohort was 21 months. A good correlation between the EZ-ALBI and ALBI scores was observed (correlation coefficient 1.000, p<0.001). The baseline EZ-ALBI grades 1, 2, and 3 were 24.5%, 70%, and 5.5%, respectively. EZ-ALBI grade can stratify patients with significantly different prognoses (p=0.002). Baseline EZ-ALBI grade 2, 3, and serum alpha-fetoprotein >20 ng/ml were significantly associated with OS [hazard ratio (HR) 2.20 (95% confidence interval [CI] 1.24-3.88, p=0.007), 3.26 (95% CI 1.24-8.57, p=0.016), and 1.77 (95% CI 1.10-2.84, p=0.018), respectively). Following TACE, 42 (29.6%) patients had a worsening EZ-ALBI grade. However, the EZ-ALBI grade migration was not significantly correlated with OS. EZ-ALBI and ALBI score provided improved discriminatory ability (Harrell’s concordance index 0.599 and 0.602, respectively) compared with Child-Turcotte-Pugh and Model for End-stage Liver Disease scores.ConclusionsThe baseline EZ-ALBI score demonstrated good predictive performance for survival and a strong correlation with conventional ALBI scores. Both the EZ-ALBI and ALBI scores outperformed other prognostic models in patients with intermediate-stage HCC receiving TACE. However, the dynamic change in the EZ-ALBI grade after TACE was not associated with postprocedural survival.

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Section: Discussionmentioning

confidence: 62%

Validation and Prognostic Value of EZ-ALBI Score in Patients with Intermediate-Stage Hepatocellular Carcinoma Treated with Trans-Arterial Chemoembolization

Ananchuensook

Sriphoosanap

Suksawatamnauy

et al. 2022

Preprint

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“…The prognosis of such patients is not only determined by the cancer itself but also by the degree of underlying liver cirrhosis (Pinter et al, 2016). Child-Pugh A (compensated cirrhosis) is a strong prognostic variable in patients with HCC after treatment (Lencioni et al, 2005;Choi et al, 2007;Hasegawa et al, 2013;Akarapatima et al, 2021), as are tumor size and response to treatment patients with early decompensated cirrhosis (HR, 0.16; 95% CI, 0.061-0.44; P <0.001) (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Overall Survival between Transarterial Chemoembolization and Best Supportive Care in Intermediate- Stage Hepatocellular Carcinoma

Akarapatima

Chang

Prateepchaiboon

et al. 2022

Asian Pac J Cancer Prev

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Objective:The Thailand management guideline allows the use of transarterial chemoembolization (TACE) for the treatment of intermediate-stage hepatocellular carcinoma (HCC) in patients with decompensated cirrhosis, whereas other guidelines do not. The aim of this study was to compare the overall survival between TACE and the best supportive care (BSC) in HCC patients with Child-Pugh score 5-8 cirrhosis and in subgroups with compensated cirrhosis (Child-Pugh score 5-6) and early decompensated cirrhosis (Child-Pugh score 7-8). Methods: This retrospective study comprised 118 patients with intermediate-stage HCC. The overall survival was compared between TACE and BSC using the Kaplan-Meier method. Results: The median overall survival time for all patients was 21.4 months in the TACE group and 8.2 months in the BSC group (P <0.001). In the subgroup analyses, the overall survival times for TACE and BSC were 26 months and 9 months, respectively, for compensated cirrhosis (P <0.001), and 14.5 months and 6.9 months, respectively, for early decompensated cirrhosis (P <0.001). In the Cox proportional-hazards model, TACE was an independent prognostic factor for prolonged overall survival in all patients [hazard ratio (HR) 0.29; 95% confidence interval (CI), 0.17-0.49; P <0.001], patients with compensated cirrhosis (HR, 0.31; 95% CI, 0.16-0.62; P <0.001), and patients with early decompensated cirrhosis (HR, 0.16; 95% CI, 0.061-0.44; P <0.001). Conclusion: TACE improves the overall survival in patients with intermediate-stage HCC and compensated or early decompensated cirrhosis.

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“…After admission, the patient's first laboratory examination data were recorded, including routine blood tests, coagulation function, liver function, and kidney function. Child-Turcotte-Pugh (CTP) score 7 : ascites, hepatic encephalopathy, serum total bilirubin (TBil), albumin (Alb), and prothrombin time (PT) were scored according to the severity of the disease, namely 1, 2 and 3 points, respectively. The score of 5 items was added, and 5-6 points were Grade A, indicating liver function compensation; 7-9 points were Grade B, indicating liver function decompensation; and 10-15 points were Grade C, indicating severe decompensation of liver function.…”

Section: Data Collection and Scoringmentioning

confidence: 99%

Risk factors for the prognosis of patients with decompensated hepatitis B cirrhosis and their predictive values.

li¹,

Zhang

Yuan

et al. 2023

Investigación Clínica

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Abstract. We aimed to investigate the risk factors affecting the progno-sis of patients with decompensated hepatitis B cirrhosis and their predictive values.The clinical data of 149 patients with decompensated hepatitis B cir-rhosis, treated from August 2015 to June 2019, were analyzed retrospectively. They were divided into death and survival groups during a one-year follow-up. Their baseline data were compared, and the risk factors affecting death, corre-lations among risk factors, and predictive values of these factors for death were analyzed. Survival analysis was conducted. During a one-year follow-up, 103 pa-tients survived, and 46 died. High neutrophil-lymphocyte ratio (NLR), red cell distribution width (RDW), the model for end-stage liver disease (MELD) score, the Child-Turcotte-Pugh (CTP) score, and low serum sodium were independent risk factors for death in patients with decompensated hepatitis B cirrhosis. NLR correlated positively with CTP and MELD scores (r=0.346, p=0.0001, r=0.243, p=0.0003, respectively). Likewise, the RDW had positive correlations with CTP and MELD scores (r=0.417, p=0.0001, r=0.413, p=0.0003, respectively). Se-rum sodium was negatively correlated with CTP and MELD scores (r=-0.484, p=0.0001, r=-0.476, p=0.0001, respectively). The survival rate was high in patients with NLR<7.38, RDW<16.15%, serum sodium>146.31 mmol/L, CTP score<10.26 points, and MELD score<11.31 points (p=0.0001). NLR, RDW, serum sodium, MELD, and CTP scores had high death predictive values.NLR, RDW, serum sodium, CTP score, and MELD score can be considered as critical indices for evaluating and predicting the prognosis of patients with decompen-sated hepatitis B cirrhosis.

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Predictive Outcomes Using Child-Turcotte-Pugh and Albumin-Bilirubin Scores in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

Cited by 5 publications

References 28 publications

Validation and Prognostic Value of EZ-ALBI Score in Patients with Intermediate-Stage Hepatocellular Carcinoma Treated with Trans-Arterial Chemoembolization

Validation and Prognostic Value of EZ-ALBI Score in Patients with Intermediate-Stage Hepatocellular Carcinoma Treated with Trans-Arterial Chemoembolization

Comparison of Overall Survival between Transarterial Chemoembolization and Best Supportive Care in Intermediate- Stage Hepatocellular Carcinoma

Risk factors for the prognosis of patients with decompensated hepatitis B cirrhosis and their predictive values.

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