ALBI Score as a Novel Tool in Staging and Treatment Planning for Hepatocellular Carcinoma: Advantage of ALBI Grade for Universal Assessment of Hepatic Function

Hiraoka, Atsushi; Michitaka, Kojiro; Kumada, Takashi; Kudo, Masashi

doi:10.1159/000481212

Cited by 31 publications

(31 citation statements)

References 5 publications

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“…ALBI grade was calculated based on serum albumin and total-bilirubin values using the following formula: ALBI-score: (log 10 bilirubin (µmol/L) × 0.66) + (albumin (g/L) × -0.085); and ALBI grade was defined by the score of the following: ≤-2.60 = Grade 1, >-2.60 to ≤-1.39 = Grade 2, >-1.39 = Grade 3 [10]. ALBI grade 2 was further divided into 2 subgrades (2a and 2b) using a previously reported cut-off value (ALBI score -2.270) and the 4 ALBI grades were named as mALBI grade [15,16].…”

Section: Methods For Assessment Of Hepatic Reserve Function and Prognmentioning

confidence: 99%

“…However, ALBI grade 2 includes patients with a wide range of hepatic function as well as those rated as Child-Pugh class B. In a recent report, a modification of ALBI grade (mALBI grade) into 4 subgrades (1, 2a, 2b, and 3) was proposed [15,16]. The present validation study aimed to evaluate the usefulness of mALBI grade for predicting the prognosis of HCC patients.…”

Section: Introductionmentioning

confidence: 99%

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Validation of Modified ALBI Grade for More Detailed Assessment of Hepatic Function in Hepatocellular Carcinoma Patients: A Multicenter Analysis

et al. 2018

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Background/Aim: The frequency of hepatocellular carcinoma (HCC) in patients with good hepatic reserve function has been increasing in Japan along with the progression of antiviral therapies and aging of the society. We evaluated the usefulness of modified albumin-bilirubin (ALBI) grade as a tool for assessment of hepatic reserve function. Materials/Methods: We enrolled 6,649 naïve HCC patients treated from 2000 to 2017 and divided them into training (Ehime Prefecture group: E group, n = 2,357) and validation (validation group: V group, n = 4,292) cohorts. Child-Pugh classification and ALBI and modified ALBI (mALBI) grading were compared using with Japan Integrated Staging (JIS), ALBI-TNM (ALBI-T), and mALBI-T scores, which were calculated based on TNM stage and each assessment tool, retrospectively. Results: In the E group, Akaike’s Information Criterion (AIC) and c-index values for mALBI-T (13,725.2/0.744) were better as compared to those of ALBI-T (13,772.6/0.733) and JIS score (13,874.7/0.720), with similar results observed in the V group (mALBI-T: 27,727.4/0.760; ALBI-T: 27,817.8/0.750; JIS: 27,807.5/0.748). Although there were some significant differences between the groups with regard to clinical background factors (age, etiology, tumor size, tumor number, treatment modalities), for all patients the AIC and c-index values of mALBI-T (45,327.1/0.755) were also better than those of ALBI-T (45,467.7/0.744) and JIS scores (45,555.8/0.739), indicating its superior stratification ability and prognostic predictive value in patients with HCC. Conclusion: The detailed stratification ability of mALBI grade for hepatic reserve function is suitable for the recent trend of HCC patients, while mALBI-T may provide a more accurate predictive value than existing total staging scoring systems.

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Section: Methods For Assessment Of Hepatic Reserve Function and Prognmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of Modified ALBI Grade for More Detailed Assessment of Hepatic Function in Hepatocellular Carcinoma Patients: A Multicenter Analysis

et al. 2018

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“…The ALBI score was calculated using the following formula: ALBI score = (log10 bilirubin × 0.66) + (−0.085 × albumin), where bilirubin is in μmol/L and albumin in g/L. The ALBI score was defined as: ALBI grade 1 (≤ −2.60), ALBI grade 2 (> −2.60 to ≤ −1.39), ALBI grade 3 (> −1.39) …”

Section: Methodsmentioning

confidence: 99%

“…Recently, various scores for assessing basic liver function or hepatic functional reserve have been advocated over the CP score, such as the albumin–bilirubin (ALBI) grade and the albumin–indocyanine green evaluation (ALICE) grade . They have been reported to be good indicators for selecting therapeutic methods or predicting survival following treatment for HCC.…”

Section: Introductionmentioning

confidence: 99%

Relationship between various hepatic function scores and the formation of esophageal varices in patients with HIV/hepatitis C virus co‐infection due to contaminated blood products for hemophilia

Yoshimoto

Eguchi

Natsuda

et al. 2018

Hepatology Research

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Aim It is reportedly difficult to accurately assess the liver reserve capacity of patients with HIV/hepatitis C virus (HCV) co‐infection through contaminated blood products by the Child–Pugh (CP) classification. Therefore, we investigated a clinically applicable scoring system in determining the risk of esophageal varices in HIV/HCV co‐infected patients, known as latent portal hypertension leading to esophageal varices. Methods Forty‐three patients with HIV/HCV co‐infection underwent clinical examinations, including endoscopy and assessment of hepatic reserve, in our department between 2009 and 2017. Child–Pugh score, the recently developed albumin–bilirubin (ALBI) grade, and the albumin–indocyanine green evaluation (ALICE) were compared to evaluate their diagnostic accuracy for the detection of esophageal varices using the area under the receiver operating characteristic curve (AUROC). Results The patients were all male hemophiliacs and were positive for both HIV and HCV antibodies, with a median age of 45 years (range, 29–66 years). Thirty‐seven patients (84.1%) were classified as CP A at the examination. The comparison of AUROCs showed a superior diagnostic accuracy for ALICE (AUROC = 0.814) to detect esophageal varices. The positive prediction rate was the highest with ALICE if −2.325 was set, and the negative prediction rate was the highest with ALBI if −2.575 was set. The ALICE showed the highest accuracy compared to other two scores. Conclusion The ALICE score was found to be the most valuable system for portal hypertension in HIV/HCV co‐infected hemophilia patients. Because of its high specificity, ALICE for secondary surveillance could be used after other markers such as the aspartate aminotransferase to platelet ratio index and Fibrosis‐4 index.

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“…Pinato et al have validated the ALBI grade in a large, multicenter and international study, and the ALBI grade was confirmed to provide objective hepatic reserve estimation across each Barcelona Clinic Liver Cancer (BCLC) stage of HCC [22]. In addition, the ALBI grade was suggested as a significant predictor for the OS of HCC patients who underwent surgical resection, transarterial chemoembolization (TACE), or sorafenib [22][23][24][25][26]. Kao et al constructed a nomogram with ALBI grade to assess the OS of patients with early-stage HCCs after RFA, in which study the personalized long-term OS data were offered [27].…”

Section: Introductionmentioning

confidence: 96%

Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

Zhang

et al. 2019

International Journal of Hyperthermia

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2019) Predictive value of the albumin-bilirubin grade on long-term outcomes of CTguided percutaneous microwave ablation in intrahepatic cholangiocarcinomaABSTRACT Purpose: To assess the efficacy of the albumin-bilirubin (ALBI) grade on assessing long-term outcomes of computed tomography (CT)-guided percutaneous microwave ablation (CT-PMWA) in the treatment of patients with intrahepatic cholangiocarcinoma (ICC). Methods: Between April 2011 and March 2018, 78 patients who underwent CT-PMWA were enrolled in this study. Overall survival (OS) and recurrence-free survival (RFS) were compared in the groups stratified by the ALBI grade and Child-Pugh score. Cox proportional hazard regression analyses were performed to determine independent predictors of OS and RFS. Results: After a median follow-up of 22.7 months (range 1-86.7 months), 67 patients had died. The cumulative 1-, 3-, and 5-year OS rates were 89.5%, 52.2%, and 35.0%, respectively. Stratified by the ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 100%, 69.2%, and 25.6% for patients with the grade 1, respectively. For patients with the ALBI grade 2, the cumulative 1-, 3-, and 5-year OS rates were 41.0%, 10.3%, and 10.3%, respectively. Patients with a hepatic function of the ALBI grade 1 had significantly higher OS rates than patients with the ALBI grade 2 (p < .001). The multivariate analysis showed tumor size (Hazard Ratio[HR] 95% Confidence Interval[CI]:9.03[1.01-80.52], p ¼ .049) and the ALBI grade (HR[95%CI]:9.56[1.58-58.00], p ¼ .014) were associated with OS, and tumor size (HR: 2.03[0.69-8.

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ALBI Score as a Novel Tool in Staging and Treatment Planning for Hepatocellular Carcinoma: Advantage of ALBI Grade for Universal Assessment of Hepatic Function

Cited by 31 publications

References 5 publications

Validation of Modified ALBI Grade for More Detailed Assessment of Hepatic Function in Hepatocellular Carcinoma Patients: A Multicenter Analysis

Validation of Modified ALBI Grade for More Detailed Assessment of Hepatic Function in Hepatocellular Carcinoma Patients: A Multicenter Analysis

Relationship between various hepatic function scores and the formation of esophageal varices in patients with HIV/hepatitis C virus co‐infection due to contaminated blood products for hemophilia

Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

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