Independent Analysis of Albumin-Bilirubin Grade in a 765-Patient Cohort Treated with Transarterial Locoregional Therapy for Hepatocellular Carcinoma

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• 作者：Ryan Hickey ; MD^a ; Samdeep Mouli ; MD^a ; Laura Kulik ; MD^b ; Kush Desai ; MD^a ; Bartley Thornburg ; MD^a ; Daniel Ganger ; MD^b ; Talia Baker ; MD^d ; Michael Abecassis ; MD^d ; Joseph Ralph Kallini ; MD^a ; Ahmed Gabr ; MD^a ; Vanessa L. Gates ; MD^a ; Al B. Benson III ; MD^c ; Robert J. Lewandowski ; MD^a ; Riad Salem ; MD ; MBA^a ; ^b ; ^d ; ^{r-salem@northwestern.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ALBI ; albumin-bilirubin ; BCLC ; Barcelona Clinic Liver Cancer ; C-P ; Child-Pugh ; CI ; confidence interval ; ECOG ; Eastern Cooperative Oncology Group ; HCC ; hepatocellular carcinoma ; OS ; median overall survival ; 90Y ; yttrium-90
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：27
• 期：6
• 页码：795-802
• 全文大小：694 K

文摘

To assess validity of albumin-bilirubin (ALBI) grade as a predictor of survival in patients undergoing transarterial embolization for hepatocellular carcinoma.

Materials and Methods

Baseline albumin and bilirubin values of 765 consecutive patients treated with conventional transarterial chemoembolization or yttrium-90 (⁹⁰Y) radioembolization at a single institution were used to determine liver function according to ALBI grade. Survival outcomes were stratified by ALBI grade using Kaplan-Meier and stratified by Child-Pugh (C-P) class and Barcelona Clinic Liver Cancer (BCLC) stage. Discriminatory ability was assessed by C-index.

Results

For 428 patients receiving ⁹⁰Y radioembolization, ALBI grade yielded distinct survival curves (P < .001). When stratified by C-P class and BCLC stage, ALBI grade revealed different survival outcomes for C-P B (P = .001), BCLC A (P < .001), BCLC B (P = .001), and BCLC C (P < .001). When substratified by BCLC stage, ALBI grade was a better discriminator of survival than C-P class (C-index 0.792, 0.763, respectively). For 337 patients receiving transarterial chemoembolization, ALBI grade yielded distinct survival curves (P < .001). When stratified by C-P class and BCLC stage, ALBI grade provided distinct survival curves for C-P B (P = .02), BCLC B (P = .001), and BCLC C (P = .02). When substratified by BCLC stage, ALBI grade was a better discriminator of survival than C-P class (C-index 0.739, 0.735, respectively).

Conclusions

ALBI grade outperforms C-P class at discriminating survival in patients receiving transarterial chemoembolization or ⁹⁰Y radioembolization. ALBI grade is also valuable in patients with moderate liver dysfunction and BCLC B disease.