Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma
Abstract
:1. Introduction
1.1. Child–Pugh Classification as a Traditional Assessment Tool for Hepatic Function and Rapid Changes of Clinical Environment
1.2. A Development of New Assessment Tool for Hepatic Function: ALBI Grade
2. ALBI Grade Related to Treatment Modalities
2.1. CURATIVE Treatments
2.1.1. Liver Transplantation
2.1.2. Surgical Resection
2.1.3. RFA
2.2. Palliative Treatment
2.2.1. TACE
2.2.2. ALBI and mALBI Grading for TKI Treatments
3. Others
3.1. Combination Use of ALBI with Another Clinical Indicator
3.2. ALBI and mALBI Grading as Part of Total Staging Scoring System and Treatment Algorithms
4. Limitations of ALBI Grade
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Child-Pugh Classification | ALBI/mALBI Grades | |
---|---|---|
Total Bilirubin | score 1: <2.0 mg/dL, score 2: 2.0–3.0 mg/dL, score 3: >3.0 mg/dL | Used (µmol/L) |
Albumin | score 1: >3.5 g/dL, score 2: 2.8–3.5 g/dL, score 3: <2.8 g/dL | Used (g/L) |
Prothrombin time | score 1: >70%, score 2: 40–70%, score 3: <40% | No use |
Ascites | score 1: none, score 2: mild/controlled, score 3: moderate/refractory | No use |
Encephalopathy | score 1: none, score 2: minimal, score 3: advanced | No use |
Calculation for score | Sum up all scores and baseline score 5 | log10 bilirubin (µmol/L) × 0.66) + (albumin (g/L) × –0.085 |
Classification | A 5–6 score, B 7–9 score, C 10–15 score | ALBI grade 1: ≤−2.60, grade 2: >−2.60 to ≤−1.39, grade 3 >−1.39.mALBI grade 2a: >−2.60 to ≤−2.27. grade 2b: >−2.27 to ≤−1.39. |
Author | Area | No. of Patients | Child-Pugh A/B/C (%) | Co-Factors | Results | ||
---|---|---|---|---|---|---|---|
Liver transplantation | |||||||
Tai [19] | Japan | 81 | NA | OS | ALBI 3 vs. MELD ≥ 16 = HR 3.26 (p = 0.004) vs. 2.22 (p = 0.079) | ||
Kormberg [22] | Germany | 123 | 42.3/57.7/0 | Recurrence-free survival | AFP >100 ng/mL: HR 4.99, p < 0.001, ALBI 3: HR 3.52, p = 0.002 | ||
Zang [23] | China | 272 | 22.8/51.5/25.7 | OS and complications | AUC for ALBI vs. MELD vs. Child–Pugh for predicting 30-day mortality: 0.702 vs. 0.669 vs. 0.540. AUC for ALBI vs. MELD vs. Child–Pugh for predicting postoperative bacterial pneumonia: 0.765 vs. 0.690 vs. 0.716. AUC for ALBI vs. MELD vs. Child–Pugh for predicting early allograft dysfunction: 0.659 vs. 0.621 vs. 0.630 | ||
Surgical resection | |||||||
Ho [25] | Taiwan | 645 | 93.8/6.2/0 | OS | AIC of ALBI vs. Child-Pugh vs. MELD: 3999.7 vs. 4013.0 vs. 4013.6 | ||
Dong [26] | China | 654 solitary HCC | 100/0/0 | OS and recurrence | Five-year OS: ALBI 1 vs. 2 = 68.4% vs. 56.1%, p = 0.001. Five-year recurrence: ALBI 1 vs. 2 = 45.3% vs. 57.3%, p = 0.002 | ||
Amisaki [27] | Japan | 136 | 100/0/0 | OS, RFS | Postoperative ALBI | OS: ALBI 3; HR 3.192, p = 0.035, RFS: ALBI 3; HR 2.397, p = 0.024, | |
Zhang [28] | China | 338 | 91.1/8.9/0 | PHLF | AUC: ALBI vs. Child–Pugh class vs. MELD = 0.790 vs. 0.656 vs. 0.669 | ||
Zou [29] | China | 473 | 90.3/9.7/0 | PHLF | AUC: Child–Pugh score vs. MELD vs. ICG-R15 vs. ALBI score = 0.665 vs. 0.649 vs. 0.668 vs. 0.745 | ||
Ye [30] | China | 300 | 94.3/5.7/0 | OS and RFS | △ALBI score (>0.71 vs. ≤0.71) | Five-year OS and RFS: Low vs. high group = 84.2% and 46.9% vs. 59.7% vs. 29.3%, all p < 0.001 | |
RFA | |||||||
Chen [31] | Taiwan | 271 with BCLC stage 0 | NA | OS and RFS | OS: ALBI 2 or 3: HR 2.191, p = 0.005, RFS: HR 1.825, p = 0.001 | ||
Oh [32] | Korea | 368 with BCLC stage 0 | 100/0/0 | OS | ALBI 2 (HR 2.32, p = 0.002) | ||
Ho [33] | Taiwan | 499 | OS | AIC: ALBI vs. Child–Pugh vs. MELD = 3068.2 vs. 3097.3 vs. 3094.9 | |||
Hiraoka [34] | Japan | 1101 with tumor (<3 cm, ≤3 tumors) | 76.5/23.5/0 | OS | AIC: ALBI vs. Child–Pugh = 5990.7 vs. 6015.4 | ||
TACE | |||||||
Khalid [37] | Pakistan | 71 | 46.5/49.3/4.2 | OS | ALBI score (HR 3.06, p = 0.0380) (Child-Pugh: HR 0.64, p = 0.09) | ||
Izumoto [38] | Japan | 192 with BCLC-B stage | 84.4/15.6/0 | OS | ALBI grade 2 (HR 1.548, p = 0.048), AFP >100 ng/mL) (HR 1.540, p = 0.033), and TTTP (HR 2.157, p < 0.001) (Child–Pugh B did not remain) | ||
Mohammed [42] | USA | 123 | 0/68/32 | Acute chronic liver failure 90 days after TACE | OR 3.99, p = 0.002, AUC 0.69 (ALBI score −1.39, sensitivity/specificity = 1.0/0.38) | ||
TKIs | |||||||
Abdel-Rahman [46] | Sorafenib arm of NCT00699374 | 544 | 100/0/0 | OS (sorafenib) | ALBI 2: HR 1.531, p < 0.001 ALBI 3: HR 1.570, p = 0.047 | ||
Tada [47] | Japan | 567 | 76.7/22.8/0.5 | OS (sorafenib) | ALBI score had higher predictive power for OS from 1 to 800 days than Child–Pugh score using time-dependent ROC analysis | ||
Kuo [48] | Taiwan | 260 | 100/0/0 | OS (sorafenib) | ALBI 2: HR 2.35, p < 0.001 | ||
Hiraoka [62] | Japan | 152 | 90.1/9.9/0 | OS (lenvatinib) | mALBI grade | Prognostic factor for death in Cox hazard multiple analysis: mALBI 2b or 3 (HR 4.632, p = 0.004) [Child–Pugh score (7 or more) did not remain] (HR 2.543, p = 0.085) |
Authors | Area | No. of Patients | Results for Predicting OS | |
---|---|---|---|---|
Modified CLIP with ALBI grade | Shao [74] | Taiwan | 142 | AIC and c-index: ALBI-CLIP vs. CLIP = 995.0 vs. 1001.1, and 0.724 vs. 0.703, respectively |
Modified CLIP with ALBI grade | Chan [75] | China | 1973 | AIC and c-index: ALBI-CLIP vs. CLIP = 15493.5 vs. 15534.3, and 0.789 vs. 0.785, respectively |
Modified CLIP with ALBI grade | Cai [76] | China | 389 HBV-related patients treated with TACE | AIC: ALBI-CLIP vs. CLIP = 2620.2 vs. 2620.5, AUCs for one- and two-year survival: ALBI-CLIP vs. CLIP = 0.697 and 0.618 vs. 0.687 and 0.612, respectively |
ALBI-T | Hiraoka [72] | Japan | 2584 | MST of score 0, 1, 2, 3, 4, and 5 of ALBI-T vs. JIS: 137.7, 83.2, 53.4, 27.4, 5.0, and 1.4 vs. 97.6, 74.9, 39.7, 15.0, 4.0, and 1.0 months |
ALBI-T | Sonohara [73] | Japan | 235 treated with surgical resection (all Child-Pugh A) | ALBI-T 3, 4, 5 vs. 0, 1, 2: HR 1.94, p = 0.004 |
mALBI-T | Hiraoka [17] | Japan | 6649 | AIC and c-index: mALBI-T vs. ALBI-T vs. JIS = 45,327.1 vs. 45,467.7 vs. 45,555.8 and 0.755 vs. 0.744 vs. 0.739, respectively |
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Hiraoka, A.; Kumada, T. Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma. Appl. Sci. 2020, 10, 7178. https://doi.org/10.3390/app10207178
Hiraoka A, Kumada T. Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma. Applied Sciences. 2020; 10(20):7178. https://doi.org/10.3390/app10207178
Chicago/Turabian StyleHiraoka, Atsushi, and Takashi Kumada. 2020. "Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma" Applied Sciences 10, no. 20: 7178. https://doi.org/10.3390/app10207178
APA StyleHiraoka, A., & Kumada, T. (2020). Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma. Applied Sciences, 10(20), 7178. https://doi.org/10.3390/app10207178