Abstract
BackgroundUnderlying liver function is a major concern when applying surgical resection for hepatocellular carcinoma (HCC). We aimed to explore the capability of the albumin-bilirubin (ALBI) grade to predict post-hepatectomy liver failure (PHLF) and long-term survival after hepatectomy for HCC patients with different Barcelona Clinic Liver Cancer (BCLC) stages.MethodsBetween January 2010 and December 2014, 338 HCC patients who were treated with liver resection were enrolled. The predictive accuracy of ALBI grade system for PHLF and long-term survival across different BCLC stages was examined.ResultsA total of 26 (7.7%) patients developed PHLF. Patients were divided into BCLC 0/A and BCLC B/C categories. ALBI score was found to be a strong independent predictor of PHLF across different BCLC stages by multivariate analysis. In terms of overall survival (OS), it exhibited high discriminative power in the total cohort and in BCLC 0/A subgroup. However, differences in OS between ALBI grade 1 and 2 patients in BCLC B/C subgroup were not significant (P = 0.222).ConclusionThe ALBI grade showed good predictive ability for PHLF in HCC patients across different BCLC stages. However, the ALBI grade was only a significant predictor of OS in BCLC stage 0/A patients and failed to predict OS in BCLC stage B/C patients.
Highlights
Underlying liver function is a major concern when applying surgical resection for hepatocellular carcinoma (HCC)
Discriminative power of ALBI score to predict post-hepatectomy liver failure (PHLF) across the Barcelona Clinic Liver Cancer (BCLC) stages of HCC Figure 2a shows the predictive power of -ALBI scores for PHLF as determined by the Receiver operating characteristic (ROC) curve analyses which were the total cohort (AUC, 0.782; 95% CI, 0.701–0.862, P < 0.001), BCLC 0/A subgroup (AUC, 0.780; 95% CI, 0.670–0.889; P < 0.001), and BCLC B/C subgroup (AUC, 0.790; 95% CI, 0.680–0.900; P = 0.002)
We found that the ALBI score could predict PHLF in the total cohort and in the BCLC 0/A and BCLC B/C subgroups
Summary
Underlying liver function is a major concern when applying surgical resection for hepatocellular carcinoma (HCC). We aimed to explore the capability of the albumin-bilirubin (ALBI) grade to predict post-hepatectomy liver failure (PHLF) and long-term survival after hepatectomy for HCC patients with different Barcelona Clinic Liver Cancer (BCLC) stages. To achieve microscopically radical resection margins, patients tend to undergo extended liver resection, which increases the chances of post-hepatectomy liver failure (PHLF). This is especially obvious when patients have underlying longterm hepatic disorders, such as hepatic fibrosis and cirrhosis [7,8,9], which often result in impaired liver
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