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. 2018 Oct 16;16(1):208.
doi: 10.1186/s12957-018-1500-9.

Ability of the ALBI grade to predict posthepatectomy liver failure and long-term survival after liver resection for different BCLC stages of HCC

Ze-Qun Zhang  1 , Li Xiong  1 , Jiang-Jiao Zhou  1 , Xiong-Ying Miao  1 , Qing-Long Li  1 , Yu Wen  2 , Heng Zou  3
Affiliations

Ability of the ALBI grade to predict posthepatectomy liver failure and long-term survival after liver resection for different BCLC stages of HCC

Ze-Qun Zhang et al. World J Surg Oncol. .

Abstract

Background: Underlying liver function is a major concern when applying surgical resection for hepatocellular carcinoma (HCC). We aimed to explore the capability of the albumin-bilirubin (ALBI) grade to predict post-hepatectomy liver failure (PHLF) and long-term survival after hepatectomy for HCC patients with different Barcelona Clinic Liver Cancer (BCLC) stages.

Methods: Between January 2010 and December 2014, 338 HCC patients who were treated with liver resection were enrolled. The predictive accuracy of ALBI grade system for PHLF and long-term survival across different BCLC stages was examined.

Results: A total of 26 (7.7%) patients developed PHLF. Patients were divided into BCLC 0/A and BCLC B/C categories. ALBI score was found to be a strong independent predictor of PHLF across different BCLC stages by multivariate analysis. In terms of overall survival (OS), it exhibited high discriminative power in the total cohort and in BCLC 0/A subgroup. However, differences in OS between ALBI grade 1 and 2 patients in BCLC B/C subgroup were not significant (P = 0.222).

Conclusion: The ALBI grade showed good predictive ability for PHLF in HCC patients across different BCLC stages. However, the ALBI grade was only a significant predictor of OS in BCLC stage 0/A patients and failed to predict OS in BCLC stage B/C patients.

Keywords: Albumin-bilirubin score; BCLC classification; Child-Pugh grade; Hepatocellular carcinoma; Overall survival; Post-hepatectomy liver failure.

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Conflict of interest statement

Ethics approval and consent to participate

Written permission was given up in the current research. This research was authorized by the ethics committee of the Central South University.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Correlation between incidence and severity of PHLF and ALBI grade (a), and BCLC classification subgroups (b). PHLF, posthepatectomy liver failure; BCLC, Barcelona Clinic Liver Cancer
Fig. 2
Fig. 2
Receiver operating characteristic (ROC) curve analyses of -ALBI scores for predicting PHLF in the entire cohort and the BCLC stage subgroups (a). ROC curves for Child-Pugh score, MELD score, and -ALBI score for predicting PHLF in the entire cohort (b), BCLC 0/A subgroup (c), and BCLC B/C subgroup (d). ALBI, albumin-bilirubin; BCLC, Barcelona Clinic Liver Cancer; PHLF, posthepatectomy liver failure. MELD, model for end-stage liver disease
Fig. 3
Fig. 3
Kaplan-Meier curves demonstrating overall survival according to the a ALBI grade in the total cohort, b Child-Pugh class in the total cohort, c ALBI grade in the BCLC 0/A subgroup, d Child-Pugh class in the BCLC 0/A subgroup, e ALBI grade in the BCLC B/C subgroup, and f Child-Pugh class in the BCLC B/C subgroup. ALBI, albumin-bilirubin; BCLC, Barcelona Clinic Liver Cancer
See this image and copyright information in PMC

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