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      Comparison between Child-Pugh Score and albumin-bilirubin grade in patients treated with the combination therapy of transarterial chemoembolization and sorafenib for hepatocellular carcinoma

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          Abstract

          Background

          Albumin-Bilirubin (ALBI) grade has been proposed for the evaluation of liver function in hepatocellular carcinoma (HCC). The combination therapy of transarterial chemoembolization (TACE) and sorafenib is widely used for HCC patients with preserved liver function; our study aimed to investigate and compare the discriminating values of ALBI grade and Child-Pugh score in overall survival (OS).

          Methods

          A total of 173 HCC patients with preserved liver function (Child-Pugh A) were enrolled. The prognostic values of OS for ALBI grade and Child-Pugh score were separately investigated.

          Results

          In multivariate analyses, both ALBI grade and Child-Pugh score could significantly stratify the patients with different OS [adjusted hazard ratio (HR) 2.15 and 1.48, P<0.001 and P=0.035 for ALBI grade and Child-Pugh score]. In addition, time-dependent ROC analysis demonstrated that the ALBI grade had a better discriminatory ability than Child-Pugh score in predicting survival, especially for long-term outcomes. According to the subgroup analyses, the ALBI grade remained significant in more patient subsets and was more consistent than Child-Pugh score for the prediction of OS.

          Conclusions

          ALBI grade was better than Child-Pugh score in stratifying prognosis for HCC patients with preserved liver function (Child-Pugh A) and treated by the combination therapy of TACE and sorafenib.

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          Most cited references26

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          EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

          Valérie Vilgrain, Peter Galle, Alejandro Forner … (2018)
          Article 0 comments Cited 2623 times – based on 0 reviews     Review now
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            Hepatocellular carcinoma

            Alejandro Forner, María E Reig, Jordi Bruix (2018)
            Hepatocellular carcinoma appears frequently in patients with cirrhosis. Surveillance by biannual ultrasound is recommended for such patients because it allows diagnosis at an early stage, when effective therapies are feasible. The best candidates for resection are patients with a solitary tumour and preserved liver function. Liver transplantation benefits patients who are not good candidates for surgical resection, and the best candidates are those within Milan criteria (solitary tumour ≤5 cm or up to three nodules ≤3 cm). Image-guided ablation is the most frequently used therapeutic strategy, but its efficacy is limited by the size of the tumour and its localisation. Chemoembolisation has survival benefit in asymptomatic patients with multifocal disease without vascular invasion or extrahepatic spread. Finally, sorafenib, lenvatinib, which is non-inferior to sorafenib, and regorafenib increase survival and are the standard treatments in advanced hepatocellular carcinoma. This Seminar summarises the scientific evidence that supports the current recommendations for clinical practice, and discusses the areas in which more research is needed.
            Article 0 comments Cited 1941 times – based on 0 reviews     Review now
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              AASLD guidelines for the treatment of hepatocellular carcinoma.

              Richard Finn, Claude Sirlin, Michael Abecassis … (2018)
              Article 0 comments Cited 1185 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Transl Med
                Journal ID (iso-abbrev): Ann Transl Med
                Journal ID (publisher-id): ATM
                Title: Annals of Translational Medicine
                Publisher: AME Publishing Company
                ISSN (Print): 2305-5839
                ISSN (Electronic): 2305-5847
                Publication date (Print and electronic): April 2020
                Publication date (Print): April 2020
                Volume: 8
                Issue: 8
                Electronic Location Identifier: 537
                Affiliations
                [1 ]Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Centre for Digestive Disease and Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi’an 710032, China;
                [2 ]Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University , Xi’an 710038, China;
                [3 ]Department of Drug and Equipment, Aeromedicine Identification and Training Centre of Air Force , Xi’an 710069, China;
                [4 ]The State Key Laboratory of Cancer Biology, Department of Biochemistry and Molecular Biology, School of Basic Medicine, Fourth Military Medical University , Xi’an 710032, China
                Author notes

                Contributions: (I) Conception and design: L Liu; (II) Administrative support: H Li; (III) Provision of study materials or patients: E Wang; (IV) Collection and assembly of data: M Wang; (V) Data analysis and interpretation: Z Wang, Q Fan; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Lei Liu, MD, PhD. Department of Gastroenterology, Tangdu Hospital of the Fourth Military Medical University, No. 569 Xinsi Road, Xi’an 710038, China. Email: tdliulei@ 123456fmmu.edu.cn .
                Article
                Publisher ID: atm-08-08-537
                DOI: 10.21037/atm.2020.02.114
                PMC ID: 7214881
                PubMed ID: 32411760
                SO-VID: 2e2dba89-d862-4565-a713-0d4dd92aeb44
                Copyright © 2020 Annals of Translational Medicine. All rights reserved.
                License:

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                Date received : 29 November 2019
                Date accepted : 23 January 2020
                Categories
                Subject: Original Article

                Keywords: hepatocellular carcinoma (hcc),liver function,predictive ability,overall survival (os)
                Data availability:
                Keywords: hepatocellular carcinoma (hcc), liver function, predictive ability, overall survival (os)

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