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Usefulness of albumin–bilirubin grade for evaluation of prognosis of 2584 Japanese patients with hepatocellular carcinoma
Author(s) -
Hiraoka Atsushi,
Kumada Takashi,
Michitaka Kojiro,
Toyoda Hidenori,
Tada Toshifumi,
Ueki Hidetaro,
Kaneto Miho,
Aibiki Toshihiko,
Okudaira Tomonari,
Kawakami Takamasa,
Kawamura Tomoe,
Yamago Hiroka,
Suga Yoshifumi,
Miyamoto Yuji,
Tomida Hideomi,
Azemoto Nobuaki,
Mori Kenichiro,
Miyata Hideki,
Ninomiya Tomoyuki,
Kawasaki Hideki
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13250
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , gastroenterology , grading (engineering) , liver function , bilirubin , liver cancer , engineering , civil engineering
Background and Aim: The Child–Pugh classification has some non‐objective factors, with chronic hepatitis indistinguishable from early liver cirrhosis in Child–Pugh A. We retrospectively evaluated the efficacy of albumin–bilirubin (ALBI) grade, which has been proposed as a new classification for hepatic function, for grading hepatocellular carcinoma (HCC) patients based on hepatic function and predicting their prognosis. Method: From 2000 to 2014, 2584 naïve HCC [69.0 ± 9.8 years old, 1850 men, 734 female, Child–Pugh class A:B:C = 1871:558:155] were enrolled. TNM staging was determined using the classification of the Liver Cancer Study Group of Japan and ALBI grade, instead of Child–Pugh classification (ALBI with TNM score: ALBI‐T score) (Table 1), and is similar to the Japan Integrated Staging (JIS) score. We retrospectively compared ALBI‐T and JIS scores in these patients. Results: Of patients classified as Child–Pugh A ( n = 1871), 1285 with 5 points were divided into 858 with ALBI grade 1 and 427 with grade 2, while 586 with 6 points were divided into 53 with grade 1 and 533 with grade 2. The ratio of ALBI grade 2 patients with a Child–Pugh score of 6 points (91.0%) was similar to that of those with 7 points (91.8%). Patients with a lower ALBI‐T score (0–5 points) showed a better median survival time than those with a corresponding lower JIS score [137.7:83.2:53.4:27.4:5.0:1.4 vs 97.6:74.9:39.7:15.0:4.0:1.0 months]. Conclusion: Albumin–bilirubin grade was found to be superior for distinguishing patients with better hepatic function. ALBI‐T scoring may be a better total prognostic scoring system for predicting survival of Japanese patients with HCC.