The Role of Novel Prognostic Scores for Patients With Hepatocellular Carcinoma

Abstract

To evaluate the role of the albumin-bilirubin (ALBI) score and grade and the inflammation-based index (IBI) for treatment outcome and morbidity assessment in patients with hepatocellular carcinoma treated with stereotactic body radiotherapy (SBRT). Patients with HCCs with Barcelona-Clinic Liver Cancer (BCLC) classification stage B or C were treated with SBRT in 3 to 12 fractions. The ALBI grade and the IBI were calculated at different time points (baseline, during and at the end of treatment and at follow up) and were compared with the Child-Turcotte-Pugh (CTP) score. Forty patients with 47 lesions were treated with SBRT. The median follow-up was 14.3 months. The median overall survival (OS) from SBRT was 10 (95% CI 8.3-11.6) months and the local control at 1 year was 79%. Predictors associated with OS were CTP score at first follow up (p=0.05) and IBI during treatment (p=0.03). Higher C-reactive protein (CRP) serum concentrations at baseline (HR: 1.043, p=0.001), during treatment (HR: 1.024, p=0.02) and at the end of treatment (HR: 1.031, p=0.02) correlated with worse OS. Higher IBI at the first follow up (18 vs 8 months, p=0.006) correlated with a worse overall survival. Patients with higher CTP (p=0.001) and ALBI score (p=0.02) at baseline were at risk for grade > 2 toxicities. Both ALBI score and CTP are useful for risk assessment in patients treated with SBRT and IBI could be a predictor for OS. These results should be further evaluated in prospective studies.