Clinical Utility of Albumin Bilirubin Grade as a Prognostic Marker in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: a Systematic Review and Meta-analysis.

Autor: Mishra G; Gastroenterology Department, Monash Medical Centre, Melbourne, Australia. Gauri.Mishra@monashhealth.org.; School of Clinical Sciences, Monash University, Melbourne, Australia. Gauri.Mishra@monashhealth.org., Majeed A; School of Clinical Sciences, Monash University, Melbourne, Australia.; Gastroenterology Department, Alfred Health, Melbourne, Australia., Dev A; Gastroenterology Department, Monash Medical Centre, Melbourne, Australia.; School of Clinical Sciences, Monash University, Melbourne, Australia., Eslick GD; The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Sydney, Australia., Pinato DJ; Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK., Izumoto H, Hiraoka A; Gastroenterology Centre, Ehime Prefectural Central Hospital, Matsuyama, Japan., Huo TI; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.; Institute of Pharmacology, National Yang-Ming University School of Medicine, Taipei, Taiwan., Liu PH; Internal Medicine, University of Texas Southwestern Medical Centre, Dallas, Texas, USA., Johnson PJ; Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK., Roberts SK; School of Clinical Sciences, Monash University, Melbourne, Australia.; Gastroenterology Department, Alfred Health, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Journal of gastrointestinal cancer [J Gastrointest Cancer] 2023 Jun; Vol. 54 (2), pp. 420-432. Date of Electronic Publication: 2022 May 30.
DOI: 10.1007/s12029-022-00832-0
Abstrakt: Purpose: Hepatic function is a key prognostic marker in patients with hepatocellular cancer (HCC) and central to patient selection for transarterial chemoembolization (TACE). We investigated the clinical utility of the Albumin-Bilirubin (ALBI) grade, an emerging prognostic model, in this heterogenous cohort via a meta-analysis of published studies.
Methods: Publications including full text articles and abstracts regarding ALBI grade were sourced by two independent researchers from databases including PubMed, Embase, Medline and Cochrane Library. Studies analysing patients with HCC undergoing TACE treatment were systematically screened utilising the PRISMA tool for data extraction and synthesis, after exclusion of duplicates, irrelevant studies and overlapping cohorts. The primary outcome was overall survival (OS), as determined by ALBI grade and assessed by hazard ratio (HRs) with 95% confidence intervals (CIs), with analysis of collated data using comprehensive meta-analysis, version 3.0 software.
Results: Eight studies were included, with a pooled population of 6538 patients with HCC that underwent TACE treatment. Higher pre-treatment grade was associated with poor OS, with median OS of 12.0 months (P < 0.001) in ALBI grade 3, compared to 33.5 months in ALBI grade 1 (P < 0.001). Significant heterogeneity within each ALBI grade was associated with age and tumour size (P < 0.001) in ALBI grades 1 and 2. In contrast, age and alcohol-related liver disease were significant in the ALBI grade 3 group (P < 0.001).
Conclusions: High pre-treatment ALBI grade is associated with poorer prognosis in patients with HCC undergoing TACE therapy. The ALBI grade demonstrates clinical utility for clinical prognostication and patient selection for TACE.
(© 2022. Crown.)
Databáze: MEDLINE
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