Albumin - bilirubin (ALBI) versus Child-Turcotte-Pugh (CTP) in prognosis of HCC after stereotactic body radiation therapy

• Published in: Radiation oncology (London, England) Vol. 14; no. 1; p. 50
• Main Authors: Su, Ting-Shi, Yang, Hai-Ming, Zhou, Ying, Huang, Yong, Liang, Ping, Cheng, Tao, Chen, Long, Li, Le-Qun, Liang, Shi-Xiong
• Format: Journal Article
• Language: English
• Published: England BioMed Central 27.03.2019; BMC
• Subjects: Adult; Aged; Albumin; Albumin–bilirubin; Background radiation; Bilirubin; Bilirubin - blood; Biomarkers, Tumor - analysis; Biopsy; Cancer therapies; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Child-Turcotte-Pugh; Classification; Dosimetry; Female; Hepatitis; Hepatocellular carcinoma; Humans; Liver; Liver cancer; Liver diseases; Liver Neoplasms - blood; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Medical prognosis; Middle Aged; Patients; Prognosis; Quality; Radiation; Radiation therapy; Radiosurgery - mortality; Retrospective Studies; Serum Albumin, Human - analysis; Severity of Illness Index; Stereotactic body radiation therapy; Survival; Survival analysis; Survival Rate; United States > US; Hepatocellular carcinoma; Albumin–bilirubin; Prognosis; Stereotactic body radiation therapy; Child-Turcotte-Pugh
• DOI: 10.1186/s13014-019-1251-y
• ISSN: 1748-717X

Child-Turcotte-Pugh (CTP) score extensively used to assess hepatic function, predicting postoperative outcome of hepatocellular carcinoma (HCC) patients. Lately, the albumin-bilirubin (ALBI) grade has been identified to be a predictor of overall survival of HCC patients. In this investigation, we compared the pre-SBRT ALBI and CTP scores with the prognosis of patients with HCC. This cohort study included 594 HCC patients who treated with SBRT. Overall survival (OS) rates were measured from treatment date to death date or last follow-up. We compared ALBI score with the CTP score in predicting long-term survival. The average follow-up time was 21 months (1 to 82 months). The CTP and ALBI ratings have discriminatory for long-term survival across the groups. CTP class was significantly related to OS, with a median OS of 29.9 months in CTP-A, 11.5 in CTP-B (P < 0.0001). ALBI grade is also significantly related to OS, with a median OS of 53.0 months in ALBI-1, 19.5 months in ALBI-2, and 6.5 months in ALBI-3(P < 0.0001). Within CTP-A class, CTP score-A5/A6 and ALBI grade has a similar predictive power (all P < 0.001). However, both CTP score and ALBI grade have no predictive power in CTP ≥ B7 class (all P>0.05). To assess liver dysfunction in HCC patients before SBRT, traditional CTP classification is a necessary but imperfect tool for assessing HCC liver injury. The ALBI score is a more objective, discriminatory and evidence-based approach in CTP-A groups, and need to be validated in CTP ≥ B7 class.