Comparison of Child-Turcotte-Pugh score and albumin bilirubin index score for advanced hepatocellular carcinoma at an LMIC tertiary cancer facility.

Abstract

e16174 Background: Liver cancer, most commonly HCC, ranks third in cancer-related deaths. Hepatic dysfunction is a key factor in management. BCLC Staging uses CTP Score with objective biosynthetic and subjective parameters as ascites and encephalopathy. Albumin-bilirubin Index (ALBI) grade is an objective method of assessing hepatic dysfunction. Many studies have validated its predictive accuracy. The present study is an attempt to study the clinical profile, risk factor and to compare ALBI with CTP Score as a predictive marker of hepatic function in HCC. Methods: This is a prospective observational study from Feb 2022-Jan 2023. Patients with suspected HCC had physical examination and relevant lab investigations. Diagnosis is established with either appropriate imaging with raised AFP or by Histopathology. ECOG PS, CTP score, ALBI Grade, and BCLC Stage of HCC were assigned. Patients were treated accordingly and are being actively followed. The data was analysed using SPSS with appropriate statistical tests to study their clinical profile and the correlation between the two prognostic scores. Results: There were 54 new patients of HCC with 78.6% being males. Mean age of presentation was 60.88±10.6 yr, with majority had abdominal pain and distension. 78% were diagnosed on imaging with raised AFP. 31 had viral hepatitis with 19 having hepatitis B, and 12 Hepatitis C. 2 were HIV+ with Hepatitis B. 50% were alcoholic. 4 patients had active autoimmune conditions with 2 having RA, 1 had AIH and 1 having AS. 75% had cirrhosis with the majority having>50% liver involvement,61% having portal vein and bile duct invasion. 10,28, and 11 patients belonged to CTP class A,B and C respectively. 57% fell to BCLC Stage 3. 5,21,28 patients belonged to ALBI Grade 1,2 and 3 respectively. The higher ALBI Index had poorer biochemical, radiological profiles and BCLC Stages, signifying the similarity in prognostic severity. Positive correlation found between the CTP score and the ALBI grade (r=0.339; P Value=0.012). Conclusions: The above study concluded ALBI Index as a good prognostic tool for HCC management in low and middle-income countries. It has only 2 biochemical parameters, can easily be done on a single visit and as it correlates significantly with CTP Score.[Table: see text]