Prognostic value of the ALBI grade among patients with single hepatocellular carcinoma without macrovascular invasion

Abstract

Although evidence for the application of an albumin-bilirubin (ALBI) grading system to assess liver function in hepatocellular carcinoma (HCC) is available, less is known whether it can be applied to determine the prognosis of single HCC with different tumor sizes. This study aimed to address this gap. Here, we enrolled patients who underwent hepatectomy due to single HCC from 2010 to 2014. Analyses were performed to test the potential of the ALBI grading system to monitor the long-Term survival of single HCC subjects with varying tumor sizes. A total of 265 participants were recruited. The overall survival (OS) among patients whose tumors were 7cm was remarkably higher than those whose tumors were 7cm. The Cox proportional hazards regression model identified the tumor differentiation grade, ALBI grade, and maximum tumor size as key determinants of OS. The ALBI grade could stratify the patients who had a single tumor 7cminto 2 distinct groups with different prognoses. The OS between ALBI grades 1 and 2 was comparable for patients who had a single tumor 7cm. We showed that the ALBI grading system can predict disease outcomes in patients with a single HCC with a tumor size 7cm. However, the ALBI grade may not predict the prognosis of patients with a single tumor 7cm. Abbreviations: AFP = alpha-fetoprotein, ALBI = albumin-bilirubin, BCLC = Barcelona Clinic for Liver Cancer, CLIP = Cancer of the Liver Italian Program, HBV = hepatitis B virus, HCC = hepatocellular carcinoma, MVI = microvascular invasion, OS = overall survival, ROC = receiver operating characteristic.