The role of albumin-bilirubin grade in determining the outcomes of patients with very early-stage hepatocellular carcinoma

被引:11
作者
Chang, Chung-Yu [1 ,2 ]
Wei, Cheng-Yi [1 ]
Chen, Ping-Hsien [3 ,4 ,5 ]
Hou, Ming-Chih [1 ,4 ]
Chao, Yee [4 ,6 ]
Chau, Gar-Yang [4 ,7 ]
Lee, Rheun-Chuan [4 ,8 ]
Huang, Yi-Hsiang [1 ,4 ,9 ]
Su, Yu-Hui [10 ]
Wu, Jaw-Ching [9 ,11 ,12 ]
Su, Chien-Wei [1 ,4 ,13 ]
机构
[1] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol & Hepatol, 201,Sect 2,Shi Pai Rd, Taipei 112, Taiwan
[2] Taipei Vet Gen Hosp, Healthcare & Serv Ctr, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Endoscopy Ctr Diag & Treatment, Taipei, Taiwan
[4] Natl Yang Ming Univ, Fac Med, Sch Med, Taipei, Taiwan
[5] West Garden Hosp, Dept Med, Div Gastroenterol & Hepatol, Taipei, Taiwan
[6] Taipei Vet Gen Hosp, Dept Oncol, Taipei, Taiwan
[7] Taipei Vet Gen Hosp, Dept Surg, Div Gen Surg, Taipei, Taiwan
[8] Taipei Vet Gen Hosp, Dept Radiol, Taipei, Taiwan
[9] Natl Yang Ming Univ, Sch Med, Inst Clin Med, Taipei, Taiwan
[10] Soochow Univ, Sch Business, Dept Accounting, Taipei, Taiwan
[11] Taipei Vet Gen Hosp, Dept Med Res, Taipei, Taiwan
[12] Natl Yang Ming Univ, Canc Progress Res Ctr, Taipei, Taiwan
[13] Taipei Vet Gen Hosp, Hospitalist Ward, Dept Med, Taipei, Taiwan
关键词
Barcelona Clinic Liver Cancer; Hepatocellular carcinoma; Prognosis; Radiofrequency ablation; Surgery;
D O I
10.1097/JCMA.0000000000000482
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Patients with hepatocellular carcinoma (HCC) and with a single tumor <2 cm in size are classified as having Barcelona Clinic Liver Cancer (BCLC) stage 0 HCC. We aimed to investigate the role of the albumin-bilirubin (ALBI) grade in predicting outcomes in patients with BCLC stage 0 HCC. Methods: We retrospectively enrolled patients with BCLC stage 0 HCC in Taipei Veterans General Hospital from 2007 to 2015. Prognostic factors were analyzed using a Cox proportional hazards model and propensity score matching (PSM) analysis. Results: There were 420 patients enrolled, including 207 with ALBI grade 1, and 213 with ALBI grade 2 or 3. After a median follow-up of 60.0 months (interquartile range, 37.2-84.6 months), 179 patients died. The cumulative 5-year overall survival (OS) rates were 80.6% in patients with ALBI grade 1 and 53.7% in those with ALBI grade 2 or 3, respectively (p < 0.001). Multivariate analysis showed that age >65 years, negative hepatitis B surface in serum, creatinine >1.0 mg/dL, platelet count <= 10(5)/mm(3), tumor size >1.5 cm, nonsurgical resection (SR) therapy, and higher ALBI grade were independent risk factors related to poor OS. Patients who underwent SR had a better OS and recurrence-free survival than those who received radiofrequency ablation, which was confirmed by a multivariate analysis and PSM analysis. Conclusion: The ALBI grade can determine OS for patients with BCLC stage 0 HCC. SR can also provide a better outcome than nonsurgical treatment.
引用
收藏
页码:136 / 143
页数:8
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