The ALBI grade provides objective hepatic reserve phenotyping across each BCLC stage of hepatocellular carcinoma.

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Title: The ALBI grade provides objective hepatic reserve phenotyping across each BCLC stage of hepatocellular carcinoma.
Authors: Pinato, DJ
Sharma, R
Yen, C
Arizumi, T
Kubota, K
Bettinger, D
Jang, JW
Smirne, C
Kim, YW
Kudo, M
Howell, J
Ramaswami, R
Burlone, ME
Guerra, V
Thimme, R
Ishizuka, M
Pirisi, M
Stebbing, J
Item Type: Conference Paper
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.
Issue Date: 1-Sep-2016
Date of Acceptance: 13-Apr-2016
URI: http://hdl.handle.net/10044/1/42867
ISSN: 1600-0641
Publisher: Elsevier
Start Page: S196
End Page: S196
Journal / Book Title: Journal of Hepatology
Volume: 64
Issue: 2, Suppl.
Copyright Statement: © 2015 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
Conference Name: 50th International Liver Congress of the European-Association-for-the-Study-of-the-Liver
Keywords: ALBI
Albumins
Bilirubin
Biomarkers
Carcinoma
Hepatocellular
Liver failure
Prognosis
Retrospective studies
Gastroenterology & Hepatology
1103 Clinical Sciences
Publication Status: Published
Start Date: 2016-04-13
Finish Date: 2016-04-17
Conference Place: Barcelona, Spain
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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