Independent Analysis of Albumin-Bilirubin Grade in a 765-Patient Cohort Treated with Transarterial Locoregional Therapy for Hepatocellular Carcinoma

Ryan Hickey, Samdeep Mouli, Laura Kulik, Kush Desai, Bartley Thornburg, Daniel Ganger, Talia Baker, Michael Abecassis, Joseph Ralph Kallini, Ahmed Gabr, Vanessa L. Gates, A. B. Benson, Robert J. Lewandowski, Riad Salem*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Purpose To assess validity of albumin-bilirubin (ALBI) grade as a predictor of survival in patients undergoing transarterial embolization for hepatocellular carcinoma. Materials and Methods Baseline albumin and bilirubin values of 765 consecutive patients treated with conventional transarterial chemoembolization or yttrium-90 (90Y) radioembolization at a single institution were used to determine liver function according to ALBI grade. Survival outcomes were stratified by ALBI grade using Kaplan-Meier and stratified by Child-Pugh (C-P) class and Barcelona Clinic Liver Cancer (BCLC) stage. Discriminatory ability was assessed by C-index. Results For 428 patients receiving 90Y radioembolization, ALBI grade yielded distinct survival curves (P <.001). When stratified by C-P class and BCLC stage, ALBI grade revealed different survival outcomes for C-P B (P =.001), BCLC A (P <.001), BCLC B (P =.001), and BCLC C (P <.001). When substratified by BCLC stage, ALBI grade was a better discriminator of survival than C-P class (C-index 0.792, 0.763, respectively). For 337 patients receiving transarterial chemoembolization, ALBI grade yielded distinct survival curves (P <.001). When stratified by C-P class and BCLC stage, ALBI grade provided distinct survival curves for C-P B (P =.02), BCLC B (P =.001), and BCLC C (P =.02). When substratified by BCLC stage, ALBI grade was a better discriminator of survival than C-P class (C-index 0.739, 0.735, respectively). Conclusions ALBI grade outperforms C-P class at discriminating survival in patients receiving transarterial chemoembolization or 90Y radioembolization. ALBI grade is also valuable in patients with moderate liver dysfunction and BCLC B disease.

Original languageEnglish (US)
Pages (from-to)795-802
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number6
DOIs
StatePublished - Jun 1 2016

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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