ObjectiveTo analyze factors affecting post-hepatectomy liver failure (PHLF) of patients with hepatocellular carcinoma (HCC) and explore value of combining albumin-bilirubin (ALBI) score with standardized future liver remnant (sFLR) in prediction of PHLF.MethodsThe clinical data of patients with HCC underwent curative hepatectomy in the Second and the Fifth Departments of General Surgery of the First Hospital of Lanzhou University from January 2016 to June 2018 were retrospectively reviewed. The risk factors of PHLF were identified through the logistic regression, the area under the receiver operating characteristic curve (AUC) was used to analyze the predictive value of the ALBI score, sFLR, or ALBI score×sFLR.ResultsA total of 72 patients with HCC were enrolled, all of them were the Child-Pugh A grade. The incidence of PHLF was 27.78% (20/72) in these 72 patients with HCC, which was 12.96% (7/54) and 72.22% (13/18) in the 54 patients with ALBI- Ⅰ grade and 18 patients with ALBI- Ⅱ grade respectively, the difference was statistically significant (P<0.001). The results of multivariable analysis of PHLF showed that the PLT (OR=0.030, P=0.018), ALBI grade (OR=11.758, P=0.020), and sFLR (OR=0.835, P=0.003) were identified as the independent predictors of PHLF. The AUC for the ALBI score×sFLR in predicting the PHLF was 0.892, it was greater than that of the ALBI score (AUC=0.799) or the sFLR (AUC=0.773).ConclusionCompared with Child-pugh grade, ALBI grade is more accurate in predicting PHLF of HCC patients, and combining ALBI score with sFLR is better than sFLR or ALBI score alone in predicting PHLF of patients with HCC.
ObjectiveTo investigate the application value of albumin-bilirubin (ALBI) score in the treatment and prognosis of hepatocellular carcinoma (HCC).MethodThe literatures related to studies on the relationship between the ALBI score and the HCC were searched. The sources of ALBI score and its role in predicting the survival of patients after the liver cancer resection, liver transplantation, and non-surgical treatment such as radiofrequency ablation, radiotherapy, sorafenib treatment, and other therapies were reviewed.ResultsThe ALBI score was the independent prognostic factor after the hepatectomy. As a risk factor for the early recurrence of HCC after the radical hepatectomy, the ALBI score might help to determine the appropriate treatment based on the patient’s liver function when the recurrence occurred. As an independent predictor of mortality after the liver transplantation, the ALBI level 3 might be helpful in optimizing individual risk assessment for the liver transplantation. The ALBI score could be used as the reference tool for the clinicians to choose between the hepatectomy and non-surgical treatment in the patients with HCC.ConclusionsRole of ALBI score in evaluating liver function is no less useful than that of Child-Pugh grade. It plays an important role in evaluating prognosis and recurrence of patients with HCC, and is conducive to selection of individualized treatment for them, and formulation of treatment plan that maximizes benefit of patients.
ObjectiveTo evaluate the prognostic value of the easy albumin-bilirubin (EZ-ALBI) score for postoperative complications and long-term prognosis of hepatocellular carcinoma (HCC) patients. MethodsThe data on consecutive 1 822 HCC patients who underwent hepatectomy were obtained and retrospectively analyzed from five medical centers, including West China Hospital, Sichuan Provincial People’s Hospital, The First People’s Hospital of Neijiang City, The Second People’s Hospital of Yibin City, and People’s Hospital of Leshan City. Non-conditional logistic and Cox proportional hazards regression were used to evaluate the aspect on the postoperative complications and long-term prognosis. ResultsThe patients in EZ-ALBI grade 2 had higher incidences of severe complication (Clavein-Dindo classification>2, P=0.001), post-hepatectomy liver failure (P=0.040), length of stay>10 d (P<0.001), perioperative transfusion (P<0.001), and 90 d mortality (P<0.001). The 1-, 3- and 5-year cumulative survival rates in EZ-ALBI grade 1 group were 85.5%, 67.0%, and 58.7% while in EZ-ALBI grade 2 group were 72.7%, 51.1%, and 39.8%. Multivariate Cox proportional hazards regression manifested that patients in EZ-ALBI grade 2 had a significantly worse overall survival [HR=1.24, 95%CI (1.04, 1.48), P=0.015]. ConclusionThe EZ-ALBI score is an easy and feasible classifying method to predict postoperative complications and survival of HCC.