The ALBI grade provides objective hepatic reserve phenotyping across each BCLC stage of hepatocellular carcinoma
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
BACKGROUND & AIMS: Overall survival (OS) is a composite clinical endpoint in hepatocellular carcinoma (HCC) due to the mutual influence of cirrhosis and active malignancy in dictating patient's mortality. The ALBI grade is a recently described index of liver dysfunction in hepatocellular carcinoma, based solely on albumin and bilirubin levels. Whilst accurate, this score lacks cross-validation, especially in intermediate stage HCC, where OS is highly heterogeneous. METHODS: We evaluated the prognostic accuracy of the ALBI grade in estimating OS in a large, multi-centre study of 2426 patients, including a large proportion of intermediate stage patients treated with chemoembolization (n=1461) accrued from Europe, the United States and Asia. RESULTS: Analysis of survival by primary treatment modality confirmed the ALBI grade as a significant predictor of patient OS after surgical resection (p<0.001), transarterial chemoembolization (p<0.001) and sorafenib (p<0.001). Stratification by Barcelona Clinic Liver Cancer stage confirmed the independent prognostic value of the ALBI across the diverse stages of the disease, geographical regions of origin and time of recruitment to the study (p<0.001). CONCLUSIONS: In this large, multi-centre retrospective study, the ALBI grade satisfied the criteria for accuracy and reproducibility following statistical validation in Eastern and Western HCC patients, including those treated with chemoembolization. Consideration should be given to the ALBI grade as a stratifying biomarker of liver reserve in routine clinical practice. LAY SUMMARY: Liver failure is a key determinant influencing the natural history of hepatocellular carcinoma (HCC). In this large multi-centre study we externally validate a novel biomarker of liver functional reserve, the ALBI grade, across all the stages of HCC.
Date Issued
2017-02
Date Acceptance
2016-09-08
Citation
Journal of Hepatology, 2017, 66 (2, Suppl.), pp.338-346
ISSN
1600-0641
Publisher
Elsevier
Start Page
338
End Page
346
Journal / Book Title
Journal of Hepatology
Volume
66
Issue
2, Suppl.
Copyright Statement
© 2015 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
Identifier
https://www.sciencedirect.com/science/article/pii/S0168827816305359?via%3Dihub
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Prognosis
Carcinoma
Hepatocellular
Liver failure
ALBI
Albumins
Bilirubin
Retrospective studies
Biomarkers
VENOUS-PRESSURE GRADIENT
LIVER-DISEASE MELD
TRANSARTERIAL CHEMOEMBOLIZATION
PROGNOSIS
CANCER
MODEL
MANAGEMENT
SYSTEM
INDEX
RISK
ALBI
Albumins
Bilirubin
Biomarkers
Carcinoma
Hepatocellular
Liver failure
Prognosis
Retrospective studies
Adult
Aged
Bilirubin
Biomarkers, Tumor
Carcinoma, Hepatocellular
Chemoembolization, Therapeutic
Europe
Female
Humans
Liver
Liver Failure
Liver Neoplasms
Male
Middle Aged
Neoplasm Staging
Organ Dysfunction Scores
Prognosis
Reproducibility of Results
Serum Albumin
Survival Analysis
Liver
Humans
Carcinoma, Hepatocellular
Liver Neoplasms
Liver Failure
Bilirubin
Serum Albumin
Neoplasm Staging
Prognosis
Chemoembolization, Therapeutic
Survival Analysis
Reproducibility of Results
Adult
Aged
Middle Aged
Europe
Female
Male
Organ Dysfunction Scores
Biomarkers, Tumor
1103 Clinical Sciences
1117 Public Health and Health Services
Gastroenterology & Hepatology
Publication Status
Published
Coverage Spatial
Barcelona, Spain
Date Publish Online
2016-09-24