Preoperative Albumin-Bilirubin Score for Postoperative Solitary Hepatocellular Carcinoma within the Milan Criteria and Child-Pugh A Cirrhosis

Abstract

Surgical resection remains the initial treatment of choice for the majority of early stage hepatocellular carcinoma (HCC) patients. Although the factors that influence the prognosis of postoperative HCC patients have been well elucidated, there are a limited number of simple, objective, and distinct methods for estimating survival for postoperative patients with solitary HCC within the Milan criteria and Child-Pugh (C-P) A cirrhosis. The Albumin-Bilirubin (ALBI) score is a new evidence-based approach to assess liver function. The ALBI score eliminates subjective variables, such as ascites and encephalopathy which are the requirements for the conventional C-P grading system. This study enrolled 654 patients to determine whether the ALBI score can predict the outcomes of postoperative solitary HCC patients within the Milan criteria and C-P A cirrhosis. Our results showed the ALBI score significantly influenced the overall survival and cumulative recurrence rates. Furthermore, the ALBI score was significantly related to the degree of liver cirrhosis and serum γ-glutamyl transpeptidase (GGT) concentration in solitary HCC cases within the Milan criteria and C-P A cirrhosis. Additionally, the combination of the ALBI score and serum GGT concentration contributed to the prognosis prediction in this cohort. In conclusion, we externally validated the ALBI grade as a novel biomarker to predict prognosis for solitary HCC within the Milan Criteria and C-P A cirrhosis.

Albumin-Bilirubin Score for Predicting Post-Transplant Complications Following Adult-to-Adult Living Donor Liver Transplantation

“…The ALBI grades are usually used as an alternative index of liver function in HCC patients [ 36 , 37 ]. Most studies focused on liver resection, radiofrequency ablation, and transarterial chemoembolization, but few studies specifically discussed the impact of ALBI in liver transplantation.…”

Preoperative Prediction for Early Recurrence Can Be as Accurate as Postoperative Assessment in Single Hepatocellular Carcinoma Patients

“…The included clinical, laboratory, and imaging factors for this study are listed in Table 1. Among the laboratory factors that have been reported to be related with HCC recurrence in previous studies, those that were evaluated within one month before surgery were recorded (9,(14)(15)(16)(17). The formulae of the calculated factors including neutrophil/ lymphocyte ratio (NLR), aspartate aminotransferase (AST)/ platelet ratio index (APRI), and albumin-bilirubin (ALBI) score in this study were as follows: NLR = neutrophil count / lymphocyte count; APRI = (AST [IU/L] / upper limit normal of AST / platelet [x 10 9 /L]) x 100; and ALBI score = (log 10 bilirubin…”

Ability of the ALBI grade to predict posthepatectomy liver failure and long-term survival after liver resection for different BCLC stages of HCC

“…The survival of HCC patients undergoing liver resection depends mainly on tumor burden and hepatic function [ 15 ]. The ALBI grade was proven to be a reliable hepatic function assessment tool and could accurately predict survival in patients with extremely early or early stage HCC who underwent liver resection [ 12 , 16 – 19 ]. However, few studies have examined the role of the ALBI grade in predicting the survival of patients with intermediate and advanced stage HCC after hepatectomy.…”