Abstract
BackgroundThe albumin–bilirubin (ALBI) grade has been validated as a significant prognostic predictor for hepatocellular carcinoma (HCC). However, there is little information about the ALBI grade in patients with non-B non-C HCC (NBNC-HCC) receiving surgery.AimThis study aimed to evaluate the prognostic significance of the ALBI grade in patients with NBNC-HCC after primary curative resection.MethodFrom January 2010 to April 2016, 2137 patients with HCC who received hepatectomy were screened for study eligibility. Finally, a total of 168 NBNC-HCC patients who received primary curative resection were analyzed. The impacts of the ALBI grade on disease-free survival (DFS) and overall survival (OS) were analyzed by multivariate analysis.ResultsThere were 66 (39.3%), 98 (58.3%), and 4 (2.4%) patients with an ALBI grade of I, II, and III, respectively. Patients with an ALBI grade II/III were older (p = 0.002), more likely to have hypoalbuminemia (p < 0.001), and more commonly had Child–Pugh class B (p = 0.009) than patients with an ALBI grade I. After a median follow-up of 76 months, 74 (44%) patients experienced recurrence, and 72 (42.9%) patients died. Multivariate analysis revealed that alpha-fetoprotein (AFP) > 200 ng/mL (p = 0.021), number of tumors (p = 0.001), and tumor stage (p = 0.007) were independent prognostic factors for DFS. Additionally, AFP > 200 ng/mL (p = 0.002), ALBI grade II/III (p = 0.002), and tumor stage (p < 0.001) were independent risk factors for poor OS.ConclusionThe preoperative ALBI grade can be used to predict mortality in patients with NBNC-HCC after primary curative resection.
Highlights
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the second most frequentTsai et al BMC Gastroenterol (2021) 21:386 virus-related hepato‐ cellular carcinoma (HCC) has decreased over the last decade
This study aimed to evaluate the prognostic relevance of the ALBI grade in patients with Non-B non-C (NBNC)-HCC after primary curative resection
Patients and methods We reviewed a total of 2137 HCC patients who received surgical resection between January 2001 and April 2016 at the Kaohsiung Chang Gung Memorial Hospital
Summary
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the second most frequentTsai et al BMC Gastroenterol (2021) 21:386 virus-related HCC has decreased over the last decade. The number of HCC patients with neither HBV nor HCV infection, known as non-B, non-C HCC (NBNC-HCC), has been increasing annually and currently accounts for 11% of all HCC cases in Taiwan [7]. This has been observed in South Korea and Japan [8, 9], which are HCV-endemic countries. Multivariate analysis revealed a significantly better RFS in the NBNC-HCC group. They concluded that patients with NBNC HCC had a significantly lower risk of tumor recurrence than those with HBV and HCV derived HCC. There is little information about the ALBI grade in patients with non-B non-C HCC (NBNC-HCC) receiving surgery
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