Preoperative platelet-albumin–bilirubin grades predict the prognosis of patients with hepatitis B virus-related hepatocellular carcinoma after liver resection

Luo, Hongmei; Zhao, Shuzhen; Li, Chuan; Li-ping, Chen

doi:10.1097/md.0000000000010226

Cited by 17 publications

(11 citation statements)

References 22 publications

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“…In the present study, except for the FIB-4 index, we also showed that DM, liver cirrhosis, tumor size, histology stage, and vascular invasion were important predictors for HCC recurrence; in addition, DM, AFP, and histology stage were independent risk factors for overall survival. It was consistent with the results from the previous studies in which patient factors (DM) [32], liver background factor (liver cirrhosis) [33], and tumor factor (vascular invasion, histology stage, and AFP) [34] determined the outcomes of HCC patients.…”

Section: Discussionsupporting

confidence: 91%

The Pre- and Postoperative FIB-4 Indexes Are Good Predictors to the Outcomes of HBV-Related HCC Patients after Resection

Tsai

Yen

Huang

et al. 2019

Gastroenterology Research and Practice

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Background and Aim Liver fibrosis is associated with the prognosis of patients with hepatocellular carcinoma (HCC) after resection. The fibrosis-4 (FIB-4) index is an accurate and noninvasive marker to determine the degree of liver fibrosis. Here, we evaluated the effect of pre- and postoperative FIB-4 index in predicting the outcomes after resection of HCC in patients who have chronic hepatitis B (CHB) infection. Methods A total of 534 CHB patients with HCC who received curative hepatectomy between 2001 and 2016 at Kaohsiung Chang Gung Memorial Hospital, Taiwan, were enrolled in this study. The impact of the FIB-4 index (preoperative and the 1st year after operation) on overall survival (OS) and recurrence-free survival (RFS) was evaluated. Results There was a significant association between the preoperative FIB-4 index and Metavir fibrosis stage (p < 0.01). The multivariate analysis showed that preoperative FIB‐4 > 2 is an independent risk factor for RFS and OS after HCC curative resection [hazard ratio (HR), 1.902; 95% CI, 1.491–2.460; p < 0.001, and HR, 2.207; 95% CI, 1.420–3.429; p < 0.001, respectively]. Notably, preoperative FIB-4 is also an independent risk factor for RFS (HR, 1.219; p = 0.035) in noncirrhotic patients. Furthermore, patients had deteriorated FIB-4 1 year after operation [definition: the value (the 1st year FIB‐4 after operation minus preoperative FIB‐4) > 1] and had an adverse outcome in RFS and OS (p < 0.001, both). Conclusion The pre and postoperative FIB-4 indexes are useful clinical markers to predict the prognosis in HBV-HCC patients after curative hepatectomy.

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Section: Discussionsupporting

confidence: 91%

The Pre- and Postoperative FIB-4 Indexes Are Good Predictors to the Outcomes of HBV-Related HCC Patients after Resection

Tsai

Yen

Huang

et al. 2019

Gastroenterology Research and Practice

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“…In daily practice, these may include idiopathic or drug-induced thrombocytopenia, Helicobacter pylori infection, and iron deficiency anemia, all of which are frequently observed. In patients unaffected by such diseases, platelet-ALBI grade, which was recently introduced for patients with HCC and incorporates platelet count into the ALBI score, 26,27 may be used instead. It is possible that combining platelet count with ALBI measurement would allow more accurate determination of fibrosis stage in patients with chronic hepatitis, although this requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

Albumin–Bilirubin Score Differentiates Liver Fibrosis Stage and Hepatocellular Carcinoma Incidence in Chronic Hepatitis B Virus Infection: A Retrospective Cohort Study

Fujita

Nomura

Morishita

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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The albumin-bilirubin (ALBI) score was originally established to stratify prognosis in patients with cirrhosis. The diagnostic accuracy of ALBI score in liver fibrosis staging in patients with chronic hepatitis B remains to be investigated. The present retrospective study, therefore, aimed to evaluate the ability of this score to stage liver fibrosis in these patients. Briefly, consecutive patients with hepatitis B virus (HBV) infection who underwent liver biopsy examinations in Kagawa University Hospital were enrolled. Liver fibrosis stage was assessed using a modified Meta-Analysis of Histological Data in Viral Hepatitis score. Albumin-bilirubin scores were calculated according to the following equation: (log 10 total bilirubin [T-Bil] × 0.66) + (albumin [Alb] × −0.085). A total of 91 patients were enrolled in this study. Albuminbilirubin score was able to differentiate stage 4 from stage 3 fibrosis (P < 0.05). When an ALBI score of −2.190 was adopted as the cutoff value for differentiating stage 4 from stages 1-3, the sensitivity, specificity, and positive likelihood ratio were 85.7%, 74.0%, and 3.300, respectively. Kaplan-Meier analysis showed that baseline ALBI scores < −2.190 correlated with better hepatocellular carcinoma (HCC)-free survival (P < 0.05). In conclusion, ALBI score can be used for liver fibrosis staging in Japanese chronic hepatitis B patients and can help distinguish cirrhotic from non-cirrhotic status. Furthermore, ALBI score was useful as a prognosis biomarker in our patients, with smaller ALBI scores predicting better HCC-free survival. Because calculating ALBI score is easy using serum T-Bil and Alb alone, ALBI score will help clinicians with decision-making in management of HBV-infected patients.

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“…Platelet-albumin-bilirubin (PALBI), is also widely used to assess liver function and prognosis in HCC. [7][8][9][10][11] However, the role of platelets in HCC is quite complicated and is even conflicting. On the one hand, preoperative thrombocytopenia (platelet count (PLT) <100×10⁹/L) is a significant predictor of poor survival and high risk of recurrence in HCC.…”

Section: Introductionmentioning

confidence: 99%

<p>The Significance of Platelet–Albumin–Bilirubin (PALBI) Grade in Hepatocellular Carcinoma Patients Stratified According to Platelet Count</p>

Pang¹,

Liu²,

Wang³

et al. 2020

CMAR

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Background Platelet–albumin–bilirubin (PALBI) has been demonstrated to be superior to conventional Child–Pugh (C-P) grade in evaluating liver function and prognosis of HCC patients. However, both thrombocytosis and thrombocytopenia are unfavorable for HCC survival. The aim of this study was to preliminarily investigate the prognostic value of PALBI in HCC patients with thrombocytopenia and excluding thrombocytopenia. Methods In this retrospective cohort study, we reviewed 465 cases of HCC patients who underwent radical surgery. PALBI grade was calculated based on preoperative serological examinations. The primary outcomes were overall survival (OS) and recurrence-free survival (RFS), which were assessed by Kaplan–Meier method and Cox regression. The prognostic performances of PALBI and other models were estimated by using the concordance index (C-index). Results During a median follow-up time of 28 months, 31.6% (147/465) of patients died and 33.5% (156/465) experienced recurrence. Multivariate analyses revealed that both thrombocytosis and thrombocytopenia were independently associated with poor OS and RFS compared with normal platelet count (PLT) in HCC patients. Stratified analysis further revealed that PALBI was a significant predictor for HCC survival in patients excluding thrombocytopenia but not in patients with thrombocytopenia. In particular, in HCC patients excluding thrombocytopenia, the combination of tumor size with PALBI (C-index = 0.730, 95% CI: 0.674–0.786) may be superior to the classical Barcelona Clinic Liver Cancer (BCLC) and Cancer of Liver Italian Program (CLIP) staging systems in predicting survival. Conclusion In conclusion, PALBI grade, in particular the combination with tumor size, is an effective model for discriminating survival in HCC patients excluding thrombocytopenia but not in thrombocytopenic HCC patients.

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Preoperative platelet-albumin–bilirubin grades predict the prognosis of patients with hepatitis B virus-related hepatocellular carcinoma after liver resection

Cited by 17 publications

References 22 publications

The Pre- and Postoperative FIB-4 Indexes Are Good Predictors to the Outcomes of HBV-Related HCC Patients after Resection

The Pre- and Postoperative FIB-4 Indexes Are Good Predictors to the Outcomes of HBV-Related HCC Patients after Resection

Albumin–Bilirubin Score Differentiates Liver Fibrosis Stage and Hepatocellular Carcinoma Incidence in Chronic Hepatitis B Virus Infection: A Retrospective Cohort Study

<p>The Significance of Platelet–Albumin–Bilirubin (PALBI) Grade in Hepatocellular Carcinoma Patients Stratified According to Platelet Count</p>

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