A New Prognostic Model Based on Albumin–Bilirubin Grade for Hepatocellular Carcinoma Beyond the Milan Criteria

Background The survival of patients with advanced hepatocellular carcinoma (HCC) is highly variable due to heterogeneous tumoral characteristics. We proposed and validated an albumin–bilirubin (ALBI)-based model for HCC beyond Milan criteria, the ALBI-HOME, for these patients. Methods A total of 2186 patients were enrolled and randomly assigned to the derivation cohort ( n = 1093) and validation cohort ( n = 1093). Multivariate Cox proportional hazards model was used to determine significant prognostic factors in the derivation cohort. The performance of ALBI-HOME was evaluated in the validation cohort. Results In the Cox model, six factors were identified as independent predictors of poor survival: ALBI grade 2 [hazard ratio (HR) 1.848, 95% confidence incidence (CI) 1.556–2.195, p