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

Pinato, David J.; Sharma, Rohini; Allara, Elias; Yen, Clarence; Arizumi, Tadaaki; Kubota, Keiichi; Bettinger, Dominik; Jang, Jeong Won; Smirne, Carlo; Kim, Young Woon; Kudo, Masatoshi; Howell, Jessica; Ramaswami, Ramya; Burlone, Michela Emma; Guerra, Vito; Thimme, Robert; Ishizuka, Mitsuru; Stebbing, Justin; Pirisi, Mario; Carr, Brian I.

doi:10.1016/j.jhep.2016.09.008

Cited by 331 publications

(304 citation statements)

References 31 publications

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“…Recently, the albumin-bilirubin (ALBI) grade was established as an evidence-based model to assess liver function in patients with HCC, which only includes serum bilirubin and albumin and eliminates subjective parameters such as encephalopathy and ascites [4]. The ALBI grade has currently been proven to be an accurate predictor of postoperative outcomes and survival, which was either superior or comparable to Child-Pugh grade [13-17]. However, there is still no comparison between ALBI score with MELD score and ICG R15 in predicting postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and Indocyanine Green R15 in Predicting Posthepatectomy Liver Failure for Hepatocellular Carcinoma Patients

Zou

Yang

et al. 2018

Dig Dis

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Background: The albumin-bilirubin (ALBI) grade is a newly proposed model for assessing the hepatic function. This study aimed to compare the value of the ALBI score with Child-Pugh score, model for end-stage liver disease (MELD) score and indocyanine green (ICG) R15 in predicting posthepatectomy liver failure (PHLF). Methods: Patients undergoing curative resection for hepatocellular carcinoma (HCC) between January 2014 and June 2017 were enrolled. The values of the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were evaluated. Results: A total of 473 HCC patients were enrolled. The ALBI score was identified as an independent predictor of PHLF. The AUCs for the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were 0.665, 0.649, 0.668, and 0.745 respectively. Multivariable analyses revealed that the ALBI score was an independent predictor of PHLF regardless of the hepatectomy subgroups, but the Child-Pugh score and MELD score were not significant predictors of PHLF both in major and minor hepatectomy subgroups, and ICG R15 was only a significant predictor of PHLF in minor hepatectomy subgroup. Conclusion: The ALBI score showed superior predictive value of PHLF over Child-Pugh score, MELD score and ICG R15. We propose to use the ALBI score to evaluate surgical risk for HCC patients undergoing hepatic resection.

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Section: Introductionmentioning

confidence: 99%

A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and Indocyanine Green R15 in Predicting Posthepatectomy Liver Failure for Hepatocellular Carcinoma Patients

Zou

Yang

et al. 2018

Dig Dis

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“…Recently, the ALBI grade, a liver function assessment based on albumin and bilirubin, has been proposed in HCC patients [35]; a large multicenter study validated the prognostic value of the ALBI grade across all Barcelona Clinic Liver Cancer stages [36]. Regarding the ALBI grade, 63 of 80 patients with Child-Pugh A were classified as having ALBI grade 2 and 1 of 20 patients with Child-Pugh B as having ALBI grade 1.…”

Section: Discussionmentioning

confidence: 99%

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

et al. 2018

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Background: Sorafenib is a standard therapy for patients with advanced hepatocellular carcinoma (HCC). However, no predictive biomarkers of sorafenib efficacy have been discovered. Herein, we investigated the impact of body composition, such as skeletal muscle and visceral fat, on the prognosis of advanced HCC patients treated with sorafenib. Methods: We enrolled 100 patients with advanced HCC treated with sorafenib. Prior to receiving sorafenib therapy, skeletal muscle index (SMI) and visceral fat area (VFA) were measured using computed tomography at the third lumbar vertebra and umbilical level, respectively. Muscle depletion was defined as an SMI value < 42 cm²/m² in men and < 38 cm²/m² in women. High VFA (H-VFA) was defined as a value ≥100 cm². In addition to SMI and VFA, we also analyzed various clinical parameters as potential prognostic factors. Results: Multivariate analysis showed that having a tumor number < 7 (hazard ratio [HR] = 0.409, p < 0.001), absence of extrahepatic spread (EHS) (HR = 0.562, p < 0.001), absence of muscle depletion (HR = 0.498, p = 0.006), and H-VFA (HR = 0.556, p = 0.031) were significant factors for long-term survival. Therefore, we evaluated the prognosis of those with no muscle depletion with H-VFA. The no muscle depletion with H-VFA group showed significantly longer survival than the other group (median survival time 15.6 vs. 11.0 months, p = 0.003). Multivariate analysis showed that having a tumor number < 7 (HR = 0.454, p = 0.001), absence of EHS (HR = 0.511, p = 0.008), and no muscle depletion with H-VFA (HR = 0.454, p = 0.002) were significant predictors of survival. Conclusions: We identified no muscle depletion with H-VFA as a novel biomarker for advanced HCC patients treated with sorafenib.

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“…Additionally, albumin, as part of the ALBI grading system, has been shown to be a quantitative, useful and prognostic indicator of liver dysfunction in HCC patients (21)(22)(23)(24)(25). Albumin has previously been reported to have direct HCC growth inhibitory properties in vitro (26,27), and there is also suggestive clinical evidence for an inhibitory effect on HCC in patients (30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Serum Albumin Levels in Relation to Tumor Parameters in Hepatocellular Carcinoma Patients

Carr

Guerra

2017

Int J Biol Markers

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ORIGINAL RESEARCH ARTICLEFurthermore, albumin values have been used in the 2-parameter albumin-bilirubin (ALBI) quantitative grading system for liver function in HCC, which has in turn been incorporated into several staging systems (21-25). There is thus much recent interest in serum albumin levels in prognostication, mainly as a reflection of liver function in HCC. However, there is also some direct experimental evidence that increased albumin levels can actually suppress HCC cell growth (26,27). Viewed this way, albumin levels may influence prognosis as much by their actions on HCC biology as by their reflection of impaired liver function.In this study, we examined the clinical correlations of serum albumin levels in a large HCC patient cohort with parameters of HCC behavior, and found an inverse relationship between serum albumin levels and HCC aggressiveness. Methods Patient dataWe retrospectively analyzed a prospectively collected database of 4,139 HCC patients, as previously reported (28,29), who had full baseline tumor parameter data, including computed axial tomography (CT) scan information on HCC size, number of tumor nodules and presence of PVT and plasma AFP levels; complete blood counts; routine blood liver function tests (total bilirubin, γ-glutamyl transpeptidase [GGT] and albumin); and patient demographics. Database management conformed to legislation on privacy, and this study conformed to the ethical guidelines of the Declaration of Helsinki. Approval for this retrospective study

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

Abstract: 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.

Cited by 331 publications

References 31 publications

A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and Indocyanine Green R15 in Predicting Posthepatectomy Liver Failure for Hepatocellular Carcinoma Patients

A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and Indocyanine Green R15 in Predicting Posthepatectomy Liver Failure for Hepatocellular Carcinoma Patients

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

Serum Albumin Levels in Relation to Tumor Parameters in Hepatocellular Carcinoma Patients

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