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Impact of albumin–bilirubin grade on survival in patients with hepatocellular carcinoma who received sorafenib: An analysis using time‐dependent receiver operating characteristic
Author(s) -
Tada Toshifumi,
Kumada Takashi,
Toyoda Hidenori,
Tsuji Kunihiko,
Hiraoka Atsushi,
Michitaka Kojiro,
Deguchi Akihiro,
Ishikawa Toru,
Imai Michitaka,
Ochi Hironori,
Joko Koji,
Shimada Noritomo,
Tajiri Kazuto,
Hirooka Masashi,
Koizumi Yohei,
Hiasa Yoichi,
Tanaka Junko
Publication year - 2019
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.14564
Subject(s) - medicine , sorafenib , hepatocellular carcinoma , hazard ratio , confidence interval , receiver operating characteristic , gastroenterology , proportional hazards model , survival analysis , multivariate analysis , bilirubin , albumin , oncology
Background and Aim Albumin–bilirubin (ALBI) grade was developed as a new method to assess hepatic function. Sorafenib has been confirmed to be effective in improving survival in patients with advanced hepatocellular carcinoma (HCC). In this study, we investigated the impact of ALBI grade versus Child–Pugh classification on survival in HCC patients who received sorafenib. Methods A total of 567 patients with advanced HCC who received sorafenib were included. We analyzed survival based on Child–Pugh classification or score and ALBI grade or score. We also compared the ability of ALBI and Child–Pugh scores to predict survival using time‐dependent receiver operating characteristic analysis. Results Cumulative survival rates at 90, 180, 360, and 720 days were 84.1%, 66.6%, 47.0%, and 23.3%, respectively. Median survival was 316 days (95% confidence interval, 279–377). Both Child–Pugh classification and ALBI grade were independently associated with overall survival in multivariate analyses. In addition, overall survival differed significantly between patients with ALBI grades 1 and 2 (hazard ratio, 1.44; 95% confidence interval, 1.09–1.92, P = 0.011) among patients with a Child–Pugh score of 5. Time‐dependent receiver operating characteristic analysis showed that ALBI score predicted overall survival better than Child–Pugh score. Conclusions Albumin–bilirubin grade is a better predictor of survival in patients with advanced HCC who received sorafenib therapy than Child–Pugh classification.