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

来源：

JOURNAL OF THE CHINESE MEDICAL ASSOCIATION | 2021年 / 84卷 / 02期

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

页码：136 / 143

页数：8