Albumin‐bilirubin grade‐based nomogram of the BCLC system for personalized prognostic prediction in hepatocellular carcinoma

Ho, Shinn‐Ying; Hsu, Chia Yang; Liu, Po Hong; Hsia, Cheng Yuan; Lei, Hao Jan; Huang, Yi Hsiang; Ko, Chih Chieh; Su, Chien Wei; Lee, Rheun‐Chuan; Hou, Ming; Huo, Teh Ia

doi:10.1111/liv.14249

Cited by 29 publications

(20 citation statements)

References 30 publications

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“…By contrast, the ALBI score is calculated using only serum albumin and bilirubin levels, both of which are incorporated in the conventional C–P score, and it does not require evaluation of prothrombin time, another parameter in the C–P classification system. Recently, the ALBI score/grade has been widely used for predicting outcomes, especially in the field of HCC 17 – 19 . Regarding the analysis of clinical outcomes in PBC, Fujita et al and Chan et al reported the utility of the ALBI score as a predictive marker 20 , 21 .…”

Section: Discussionmentioning

confidence: 99%

The albumin–bilirubin score as a predictor of outcomes in Japanese patients with PBC: an analysis using time-dependent ROC

Ito

Ishigami

Morooka

et al. 2020

Sci Rep

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The albumin–bilirubin (ALBI) score is calculated using only serum albumin and bilirubin levels, and was developed as a simple method to assess hepatic function. In this study, a total of 409 patients with primary biliary cholangitis (PBC) were enrolled between March 1990 and October 2018. The predictive performances of the ALBI score and other well-established prognostic scores were compared using time-dependent receiver operating characteristic (ROC) analysis. During the follow-up period, 60 patients died, 45 due to liver-related diseases and 15 due to non-liver-related diseases, and 16 patients underwent liver transplantation. Time-dependent ROC analysis showed that the ALBI score has higher the areas under the ROC curves (AUROCs) than the Child–Pugh (C–P) score at each time point; AUROCs at 3, 5, and 10 years after the start of follow-up were 0.94, 0.91, and 0.90 for the ALBI score, and 0.89, 0.88, and 0.82 for the C–P score, respectively. The ALBI score showed the highest AUROCs within 2 years after the start of observation; beyond 2 years, however, the Mayo score had better prognostic ability for mortality and liver transplantation. The ALBI score/grade, derived from objective blood tests, and the Mayo score were superior prognostic tools in PBC patients.

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Section: Discussionmentioning

confidence: 99%

The albumin–bilirubin score as a predictor of outcomes in Japanese patients with PBC: an analysis using time-dependent ROC

Ito

Ishigami

Morooka

et al. 2020

Sci Rep

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“…Nomograms provide individual predicts of future clinical outcomes by combining the effects of various variables associated with these events. The nomogram has proven to be a reliable tool for predicting the clinical survival of many types of cancers [26][27][28][29][30]. In this study, we screened 13 miRNAs, and a nomogram was then built based on the independent prognostic variables associated with patient survival.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Based on microRNA Signature Contributes to Improve Survival Prediction of Clear Cell Renal Cell Carcinoma

Zhao

Bai

2020

BioMed Research International

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Objective. Numerous microRNAs (miRNAs) have been identified in ccRCC and recommended to be used for predicting clear cell renal cell carcinoma (ccRCC) prognosis. However, it is not clear whether a miRNA-based nomogram results in improved survival prediction in patients with ccRCC. Methods. miRNA profiles from tumors and normal tissues were downloaded from The Cancer Genome Atlas (TCGA) database and analyzed using the “limma” package. The association between differentially expressed miRNAs and patient prognosis was identified using univariate, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses. Next, all patients were randomly divided into development and validation cohorts at a ratio of 1 : 1. A nomogram was established based on independent prognostic factors in the development cohort. The prognostic performance of the nomogram was validated in both cohorts using the concordance index (C-index) and calibration plots. Results. Multivariate Cox analysis identified the 13-miRNA signature, as well as AJCC stage and age, as independent prognostic factors after adjusting for other clinical covariates. The nomogram was built based on the independent variables. In the development cohort, the C-index for the constructed nomogram to predict overall survival (OS) was 0.792, which was higher than the C-index (0.731) of the AJCC staging system and C-index (0.778) of the miRNA signature. The nomogram demonstrated good discriminative ability in the validation cohort in predicting OS, with a C-index of 0.762. The calibration plots indicated an excellent agreement between the nomogram predicted survival probability and the actual observed outcomes. Furthermore, decision curve analysis (DCA) indicated that the nomogram was superior to the AJCC staging system in increasing the net clinical benefit. Conclusions. The novel proposed nomogram based on a miRNA signature is a more reliable and robust tool for predicting the OS of patients with ccRCC compared to AJCC staging system, thus, improving clinical decision-making.

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“…The ALBI score was calculated according to the following equation = 0.66 × log 10 bilirubin (μmol/L) − 0.085 × albumin (g/L). ALBI grades were classified into three groups: ALBI grade 1 (score ≤−2.60), ALBI grade 2 (score >−2.60 and ≤−1.39) and ALBI grade 3 (score >−1.39) (12,14). The equation of estimated glomerular filtration rate (eGFR) was calculated based on the modification of diet in renal disease (MDRD) formula (22).…”

Section: Diagnosis and Definitionmentioning

confidence: 99%

“…Recently, the albumin-bilirubin (ALBI) grade, consisting of only serum albumin and bilirubin, was reported a simple and objective method to assess hepatic dysfunction. The feasibility of ALBI grade in HCC has been validated by several groups (12)(13)(14)(15). However, the prognostic role of ALBI grade in HCC patients receiving dialysis has not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

ALBI grade in dialysis patients with hepatocellular carcinoma: prognostic impact and staging strategy

Ho¹,

Liu²,

Hsu³

et al. 2021

J Gastrointest Oncol

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Background: Patients with hepatocellular carcinoma (HCC) may develop end-stage renal disease and receive dialysis, but the impact of dialysis on the prognosis is unclear. This study aimed to evaluate the outcome of dialysis HCC patients and the prognostic role of albumin-bilirubin (ALBI) grade in these patients. Methods: Among the consecutive 3,794 HCC patients between 2002-2017, 43 patients undergoing dialysis, and 129 age, sex-matched controls were analyzed. Multivariate Cox hazards model was used to identify independent prognostic predictors. Results: Dialysis patients had decreased overall survival when compared with non-dialysis patients (n=3,751) and matched controls (n=129; each P=0.004). Patients with ALBI grade 1 had the best survival in the pooled cohort of dialysis and matched controls (n=172). In the Cox model, total tumor volume >33 cm 3 [hazard ratio (HR): 6.763, P<0.001], presence of ascites (HR: 6.168, P<0.001), dialysis duration less than 24 months (HR: 3.144, P=0.006), diabetes-related dialysis (HR: 9.366, P=0.001) and non-curative treatments (HR: 9.220, P<0.001) were poor prognosis factors associated with increase mortality among dialysis patients. Of the 9currently-used HCC staging systems, the CLIP score was the optimal cancer staging for dialysis patients. Conclusions: Patients receiving dialysis had decreased overall survival compared with non-dialysis patients. Longer duration of dialysis, non-diabetes related dialysis, absence of ascites, and curative treatments were associated with improved survival in these patients. The ALBI grade is a feasible prognostic model to evaluate liver functional reserve, and the CLIP model is the best staging system for dialysis patients with HCC.

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Albumin‐bilirubin grade‐based nomogram of the BCLC system for personalized prognostic prediction in hepatocellular carcinoma

Cited by 29 publications

References 30 publications

The albumin–bilirubin score as a predictor of outcomes in Japanese patients with PBC: an analysis using time-dependent ROC

The albumin–bilirubin score as a predictor of outcomes in Japanese patients with PBC: an analysis using time-dependent ROC

Nomogram Based on microRNA Signature Contributes to Improve Survival Prediction of Clear Cell Renal Cell Carcinoma

ALBI grade in dialysis patients with hepatocellular carcinoma: prognostic impact and staging strategy

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