Assessment of the Albumin-Bilirubin (ALBI) Grade as a Prognostic Indicator for Hepatocellular Carcinoma Patients Treated With Radioembolization. (September 2018)

• Record Type: Journal Article
• Authors: Gui, Bin; Weiner, Ashley A.; Nosher, John; Lu, Shou-En; Foltz, Gretchen M.; Hasan, Omar; Kim, Seung K.; Gendel, Vyacheslav; Mani, Naganathan B.; Carpizo, Darren R.; Saad, Nael E.; Kennedy, Timothy J.; Zuckerman, Darryl A.; Olsen, Jeffrey R.; Parikh, Parag J.; Jabbour, Salma K.
• Is Part Of: American journal of clinical oncology. Volume 41:Number 9(2018)
• Publication Date: 2018-09
• Subjects: hepatocellular carcinoma -- yttrium-90 radioembolization -- prognostic indicator -- albumin-bilirubin (ALBI) grade; Cancer -- Treatment -- Periodicals; Oncology -- Periodicals; Tumors -- Periodicals; 616.994005
• DOI: 10.1097/COC.0000000000000384
• Languages: English
• ISSNs: 0277-3732

Abstract

Abstract : Objective: As the utility of Child-Pugh (C-P) class is limited by the subjectivity of ascites and encephalopathy, we evaluated a previously established objective method, the albumin-bilirubin (ALBI) grade, as a prognosticator for yttrium-90 radioembolization (RE) treatment for patients with hepatocellular carcinoma (HCC). Materials and Methods: A total of 117 patients who received RE for HCC from 2 academic centers were reviewed and stratified by ALBI grade, C-P class, and Barcelona Clinic Liver Cancer stage. The overall survival (OS) according to these 3 criteria was evaluated by Kaplan-Meier survival analysis. The utilities of C-P class and ALBI grade as prognostic indicators were compared using the log-rank test. Multivariate Cox regression analysis was performed to identify additional predictive factors. Results: Patients with ALBI grade 1 (n=49) had superior OS than those with ALBI grade 2 (n=65) ( P =0.01). Meanwhile, no significant difference was observed in OS between C-P class A (n=100) and C-P class B (n=14) ( P =0.11). For C-P class A patients, the ALBI grade (1 vs. 2) was able to stratify 2 clear and nonoverlapping subgroups with differing OS curves ( P =0.03). Multivariate Cox regression test identified alanine transaminase, Barcelona Clinic Liver Cancer stage, and ALBI grade as the strongest prognostic factors for OS ( P <0.10). Conclusions: ALBI grade as a prognosticator has demonstrated clear survival discrimination that is superior to C-P class among HCC patients treated with RE, particularly within the subgroup of C-P class A patients. ALBI grade is useful for clinicians to make decisions as to whether RE should be recommended to patients with HCC.