Proposed New Sub-Grouping for Intermediate-Stage Hepatocellular Carcinoma Using Albumin-Bilirubin Grade

Aim: We retrospectively evaluated the efficacy of albumin-bilirubin (ALBI) grade, which has been proposed as a new classification for hepatic function, for evaluation of the prognosis of intermediate-stage hepatocellular carcinoma (Barcelona Clinic Liver Cancer criteria stage B, BCLC-B). Patients an...

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Veröffentlicht in:Oncology 2016, Vol.91 (3), p.153-161
Hauptverfasser: Hiraoka, Atsushi, Kumada, Takashi, Nouso, Kazuhiro, Tsuji, Kunihiko, Itobayashi, Ei, Hirooka, Masashi, Kariyama, Kazuya, Ishikawa, Toru, Tada, Toshifumi, Toyoda, Hidenori, Kawasaki, Hideki, Hiasa, Yoichi, Michitaka, Kojiro
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container_end_page 161
container_issue 3
container_start_page 153
container_title Oncology
container_volume 91
creator Hiraoka, Atsushi
Kumada, Takashi
Nouso, Kazuhiro
Tsuji, Kunihiko
Itobayashi, Ei
Hirooka, Masashi
Kariyama, Kazuya
Ishikawa, Toru
Tada, Toshifumi
Toyoda, Hidenori
Kawasaki, Hideki
Hiasa, Yoichi
Michitaka, Kojiro
description Aim: We retrospectively evaluated the efficacy of albumin-bilirubin (ALBI) grade, which has been proposed as a new classification for hepatic function, for evaluation of the prognosis of intermediate-stage hepatocellular carcinoma (Barcelona Clinic Liver Cancer criteria stage B, BCLC-B). Patients and Methods: We enrolled 754 naïve BCLC-B patients (multiple tumors) and retrospectively analyzed their clinical features [surgical resection (hepatectomy), n = 170; radiofrequency ablation (RFA), n = 110; percutaneous ethanol injection, n = 7; transcatheter arterial chemoembolization, n = 396; others, n = 25; best supportive care, n = 46]. Four sub-groups were defined for the Modified Intermediate Stage of Liver Cancer (MICAN) criteria as follows: B1 (ALBI-1/within up-to-7 criteria), B2 (ALBI-2/within up-to-7 criteria), B3 (ALBI-1 and ALBI-2/multiple and beyond up-to-7 criteria), and B4 (ALBI-3/any). Results: The median survival time of patients classified as B1 (n = 94), B2 (n = 175), B3 (n = 452), and B4 (n = 33) was 65.1, 48.1, 29.6, and 14.6 months, respectively (p < 0.01 for each). Those in B1 treated with hepatectomy and RFA comprised 67.0%, while that ratio was 51.4% in B2, 28.3% in B3, and 12.1% in B4. Conclusion: The MICAN criteria based on ALBI grade are simple and useful for prediction of prognosis and therapy decision-making in the heterogeneous population of BCLC-B patients.
doi_str_mv 10.1159/000447061
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Patients and Methods: We enrolled 754 naïve BCLC-B patients (multiple tumors) and retrospectively analyzed their clinical features [surgical resection (hepatectomy), n = 170; radiofrequency ablation (RFA), n = 110; percutaneous ethanol injection, n = 7; transcatheter arterial chemoembolization, n = 396; others, n = 25; best supportive care, n = 46]. Four sub-groups were defined for the Modified Intermediate Stage of Liver Cancer (MICAN) criteria as follows: B1 (ALBI-1/within up-to-7 criteria), B2 (ALBI-2/within up-to-7 criteria), B3 (ALBI-1 and ALBI-2/multiple and beyond up-to-7 criteria), and B4 (ALBI-3/any). Results: The median survival time of patients classified as B1 (n = 94), B2 (n = 175), B3 (n = 452), and B4 (n = 33) was 65.1, 48.1, 29.6, and 14.6 months, respectively (p &lt; 0.01 for each). Those in B1 treated with hepatectomy and RFA comprised 67.0%, while that ratio was 51.4% in B2, 28.3% in B3, and 12.1% in B4. Conclusion: The MICAN criteria based on ALBI grade are simple and useful for prediction of prognosis and therapy decision-making in the heterogeneous population of BCLC-B patients.</description><identifier>ISSN: 0030-2414</identifier><identifier>EISSN: 1423-0232</identifier><identifier>DOI: 10.1159/000447061</identifier><identifier>PMID: 27362669</identifier><language>eng</language><publisher>Basel, Switzerland: S. 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Patients and Methods: We enrolled 754 naïve BCLC-B patients (multiple tumors) and retrospectively analyzed their clinical features [surgical resection (hepatectomy), n = 170; radiofrequency ablation (RFA), n = 110; percutaneous ethanol injection, n = 7; transcatheter arterial chemoembolization, n = 396; others, n = 25; best supportive care, n = 46]. Four sub-groups were defined for the Modified Intermediate Stage of Liver Cancer (MICAN) criteria as follows: B1 (ALBI-1/within up-to-7 criteria), B2 (ALBI-2/within up-to-7 criteria), B3 (ALBI-1 and ALBI-2/multiple and beyond up-to-7 criteria), and B4 (ALBI-3/any). Results: The median survival time of patients classified as B1 (n = 94), B2 (n = 175), B3 (n = 452), and B4 (n = 33) was 65.1, 48.1, 29.6, and 14.6 months, respectively (p &lt; 0.01 for each). Those in B1 treated with hepatectomy and RFA comprised 67.0%, while that ratio was 51.4% in B2, 28.3% in B3, and 12.1% in B4. Conclusion: The MICAN criteria based on ALBI grade are simple and useful for prediction of prognosis and therapy decision-making in the heterogeneous population of BCLC-B patients.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>27362669</pmid><doi>10.1159/000447061</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1989-0480</orcidid><orcidid>https://orcid.org/0000-0003-3996-7502</orcidid><orcidid>https://orcid.org/0000-0002-0976-6761</orcidid><orcidid>https://orcid.org/0000-0002-1652-6168</orcidid><orcidid>https://orcid.org/0000-0003-2211-495X</orcidid></addata></record>
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subjects Aged
Albumin
Bilirubin
Bilirubin - blood
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Care and treatment
Catheter Ablation
Chemoembolization, Therapeutic
Clinical Decision-Making - methods
Clinical Study
Diagnosis
Female
Health aspects
Hepatectomy
Hepatocellular carcinoma
Humans
Identification and classification
Liver Neoplasms - blood
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Male
Middle Aged
Neoplasm Staging
Prognosis
Retrospective Studies
Serum Albumin - metabolism
Survival Rate
title Proposed New Sub-Grouping for Intermediate-Stage Hepatocellular Carcinoma Using Albumin-Bilirubin Grade
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