PTH-120 Albi score predicts survival independently of hepatic venous pressure gradient (HVPG) and indocyanine green (ICG) clearance in HCC patients undergoing resection

Onali, Simona; Marshall, Aileen; Sharma, Dheeraj; O'Donoghue, P; Dannhorn, E; Johnson, Philip J.; O’Beirne, James

doi:10.1136/gutjnl-2015-309861.1008

Cited by 2 publications

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“…All patients in this report were deemed unsuitable for transplant, resection, TACE or RFA, with 55% having macrovascular invasion, and as such would be expected to fare less well than those suitable for established treatments 8 . Other groups have also found ALBI grade to be useful in determining outcomes amongst HCC patients undergoing liver resection, TACE, radioembolization and systemic therapies, and frequently ALBI is more discriminating than CP scores [13][14][15][16][17] . Other groups have also investigated the incorporation of ALBI within other recognised staging systems 18,19 .…”

Section: Discussionmentioning

confidence: 99%

Baseline Albumin-Bilirubin (ALBI) Score in Western Patients With Hepatocellular Carcinoma Treated With Stereotactic Body Radiation Therapy (SBRT)

Murray

Sykes

Brierley

et al. 2018

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 99%

Baseline Albumin-Bilirubin (ALBI) Score in Western Patients With Hepatocellular Carcinoma Treated With Stereotactic Body Radiation Therapy (SBRT)

Murray

Sykes

Brierley

et al. 2018

International Journal of Radiation Oncology*Biology*Physics

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“…(2) Patients underwent a hepatic venous pressure gradient (HVPG) and indocyanine green clearance measurement as part of the protocol used to assess resectability. All subjects were Child-Pugh A5 and had a performance status of 0.…”

Section: To the Editormentioning

confidence: 99%

Selection criteria for resection in hepatocellular carcinoma: Can we expand them?

Onali

Figorilli

2015

Hepatology

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We read with interest the article by Roayaie et al. (1) regarding the surgical management of hepatocellular carcinoma (HCC) within the Bridge database. As reported by the authors, about two-thirds of resected patients were not ideal candidates for surgery according to published guidelines; in particular, 37% had portal hypertension (PH), and 7% were Child-Pugh B-C. However, factors traditionally associated with poor outcome, such as PH and bilirubin >1 mg/dL, were not correlated with survival if taken separately. Therefore, the authors suggest that selection criteria might be safely expanded to include patients with moderately elevated bilirubin or PH, highlighting the importance of considering both PH and liver function when assessing patients for resection.We recently published the results of a wellcharacterized cohort of HCC patients (n 5 48) undergoing liver resection at our center between 2010 and 2014.(2) Patients underwent a hepatic venous pressure gradient (HVPG) and indocyanine green clearance measurement as part of the protocol used to assess resectability. All subjects were Child-Pugh A5 and had a performance status of 0. Median HVPG was 6 mm Hg (range 2-15), and 11 (23%) patients had HVPG 10 mm Hg but preserved liver function, defined as indocyanine green retention at 15 minutes of <15%. Four (8%) had bilirubin >1 mg/dL. In line with Roayaie et al., we found no correlation between PH and survival. Moreover, we have also explored the role of the albumin-bilirubin (ALBI) score, a newly developed HCC prognostic score in patients undergoing assessment for liver resection. (3,4) In our cohort (n 5 67) ALBI was the only factor significantly correlated with survival, independently of Child-Pugh score and HVPG. Interestingly, of resected patients, only two (4%) were classified as ALBI 2, suggesting that ALBI 2 patients are unlikely to be considered suitable candidates for resection.In conclusion, we agree that current selection criteria for resection in HCC can be expanded to include patients with moderate PH, provided that an accurate assessment of liver function is performed. In this setting, indocyanine green clearance measurement appears to be a reliable method to evaluate liver function and ALBI score can identify patients who are unlikely to be suitable candidates for resection.

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PTH-120 Albi score predicts survival independently of hepatic venous pressure gradient (HVPG) and indocyanine green (ICG) clearance in HCC patients undergoing resection

Cited by 2 publications

References 0 publications

Baseline Albumin-Bilirubin (ALBI) Score in Western Patients With Hepatocellular Carcinoma Treated With Stereotactic Body Radiation Therapy (SBRT)

Baseline Albumin-Bilirubin (ALBI) Score in Western Patients With Hepatocellular Carcinoma Treated With Stereotactic Body Radiation Therapy (SBRT)

Selection criteria for resection in hepatocellular carcinoma: Can we expand them?

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