TY - JOUR
T1 - Independent Analysis of Albumin-Bilirubin Grade in a 765-Patient Cohort Treated with Transarterial Locoregional Therapy for Hepatocellular Carcinoma
AU - Hickey, Ryan
AU - Mouli, Samdeep
AU - Kulik, Laura
AU - Desai, Kush
AU - Thornburg, Bartley
AU - Ganger, Daniel
AU - Baker, Talia
AU - Abecassis, Michael
AU - Ralph Kallini, Joseph
AU - Gabr, Ahmed
AU - Gates, Vanessa L.
AU - Benson, A. B.
AU - Lewandowski, Robert J.
AU - Salem, Riad
N1 - Publisher Copyright:
© 2016 SIR.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84962077673&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84962077673&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2016.03.005
DO - 10.1016/j.jvir.2016.03.005
M3 - Article
C2 - 27038686
AN - SCOPUS:84962077673
VL - 27
SP - 795
EP - 802
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 6
ER -