Prognostic role of preoperative albumin-bilirubin grade on patients with hepatocellular carcinoma after surgical resection: a systematic review and meta-analysis

Abstract

Recent studies have reported albumin-bilirubin (ALBI) grade affected the prognosis of patients with hepatocellular carcinoma (HCC). To more precisely evaluate the relationship among the ALBI grade and the prognosis of patients with HCC after liver resection. We systematically retrieved articles from PubMed, Web of Science, Cochrane Library, and CNKI. The prognostic value of ALBI grade on overall survival (OS) and recurrence-free survival (RFS) of patients with HCC after liver resection was evaluated by pooled hazard ratio (HR) with 95% confidence interval (CI).Through multiple databases search, we enrolled 20 high-quality studies with 11365 patients, regarding the association between the ALBI grade and the prognosis of patients with HCC after liver resection. Our results showed that higher ALBI grade is associated with poored OS (HR, 1.64; 95% CI: 1.51–1.78; P < 0.001; I2 = 24.9%) and RFS (HR, 1.42; 95% CI: 1.26–1.59; P < 0.001; I2 = 0). Moreover, subgroup analysis showed the significant correlation between ALBI grade and poor long-term survival was not altered in different geographical areas, sample sizes, follow-up duration, and quality scores. The ALBI grade may be as effective predictive biomarkers for prognosis in patients with HCC after liver resection.

Circular RNA hsa_circ_0000437 may be used as a new indicator for the diagnosis and prognosis of hepatocellular carcinoma

“…Our findings suggest that patients with high levels of circ_00004378 had significantly shorter OS than that of patients with low levels. In a study by Geng et al, a high albumin-bilirubin (ALBI) grade was associated with poor OS among patients with HCC after liver resection, and the ALBI grade may be a predictive biomarker for prognosis in HCC [ 20 ]. Similarly, circ_00004378 may serve as an indicator for HCC prognosis.…”

Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis

“…The Child–Pugh classification remains the most applied method for the evaluation of the liver reserve in the preliminary evaluations for LR [ 3 ]. However, in recent years, concerns regarding the adequacy of the Child–Pugh classification have emerged due to the subjectivity and insufficient ability in stratifying the individual risks of patients with mild severity liver diseases [ 14 , 51 , 52 ]. Instead, the ALBI grade showed a greater accuracy in further stratifying the prognosis of HCC patients belonging to Child–Pugh class A [ 14 , 52 , 53 ].…”

“…Instead, the ALBI grade showed a greater accuracy in further stratifying the prognosis of HCC patients belonging to Child–Pugh class A [ 14 , 52 , 53 ]. Two recent meta-analyses including HCC patients [ 16 , 51 ] reported a higher predictive value of the ALBI grade compared to the Child–Pugh class for stratifying patient survival.…”

“…Indeed, higher ALBI grades were associated with poor overall survival (OS) (HR = 2.060, 95% CI: 1.909–2.211, p = 0.000) [ 16 ] even in HCC patients undergoing LR [ 51 ]. Another recent meta-analysis [ 54 ] confirmed that the ALBI grade was able to better stratify the prognosis of HCC patients undergoing treatments.…”

Prognostic Value of Platelet-Albumin-Bilirubin Grade in Child-Pugh A and B Patients With Hepatocellular Carcinoma: A Meta-Analysis

“…A new assessment model for liver function, called the albumin-bilirubin (ALBI) grade, was introduced by Johnson in 2015 ( 7 ). ALBI grade can effectively reflect the liver function and may predict the prognosis of HCC patients ( 8 , 9 ). Subsequently, a meta-analysis found that the ALBI grade had good diagnostic value in predicting post-hepatectomy liver failure in HCC patients undergoing liver resection ( 10 ).…”