Assessment of the Albumin-Bilirubin (ALBI) Grade as a Prognostic Indicator for Hepatocellular Carcinoma Patients Treated With Radioembolization
Autor: | Bin Gui, John L. Nosher, Shou-En Lu, Timothy J. Kennedy, Jeffrey R. Olsen, Salma K. Jabbour, Ashley A. Weiner, Seung Kwon Kim, Omar Hasan, Vyacheslav Gendel, Naganathan Mani, Darryl A. Zuckerman, Parag J. Parikh, Darren R. Carpizo, Nael Saad, Gretchen Foltz |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Carcinoma Hepatocellular Bilirubin Encephalopathy Serum Albumin Human Gastroenterology Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Ascites Carcinoma medicine Biomarkers Tumor Humans Chemoembolization Therapeutic Survival rate Technetium Tc 99m Aggregated Albumin Aged Retrospective Studies Aged 80 and over business.industry Liver Neoplasms Albumin Retrospective cohort study Middle Aged medicine.disease Prognosis Surgery Survival Rate Oncology chemistry 030220 oncology & carcinogenesis Hepatocellular carcinoma 030211 gastroenterology & hepatology Female medicine.symptom business Follow-Up Studies |
Zdroj: | American journal of clinical oncology. 41(9) |
ISSN: | 1537-453X |
Popis: | 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).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.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 (P0.10).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. |
Databáze: | OpenAIRE |
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