Abstract
To assess validity of albumin-bilirubin (ALBI) grade and platelet-albumin-bilirubin (PALBI) grade as a predictor of survival in patients undergoing transarterial embolization for hepatocellular carcinoma. Baseline platelet, albumin, and bilirubin values of 172 patients treated with transarterial chemoembolization for primary hepatocellular carcinoma at a single institution were used to determine liver function according to ALBI and PALBI grade via retrospective chart review. Progression free survival, and overall survival outcomes were stratified by ALBI grade, PALBI grade, and by Child-Pugh (C-P) class for comparison, using Kaplan-Meier Analysis. Post op response was assessed using Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) and was categorized according to mRECIST guidelines. Survival was defined by date of death available by chart review or living status on February 1st, 2018. ALBI grade proved a better predictor of overall survival (p= 0.009) than PALBI grade (p=0.081). ALBI score also proved a significant predictor of PFS (p=0.008) compared to PALBI score (p=0.095). CP demonstrated better separation of overall survival curves by grade compared to both ALBI and PALBI, but proved a worse predictor of PFS (p=0.316). ALBI grade is an adequate model to assess liver function in HCC and predict progression free survival and overall survival post-TACE, and exceeds CP as a predictor of progression free survival.
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