Perioperative and prognostic implication of albumin‐bilirubin‐TNM score in Child‐Pugh class A hepatocellular carcinoma

BACKGROUND AND AIM: A reliable classification for predicting postoperative prognosis and perioperative risk of hepatocellular carcinoma (HCC) patients is required to make a precise decision for HCC treatment. In the present study, we assessed the perioperative and prognostic importance of indocyanine green (ICG) testing, tumor‐node‐metastasis (TNM) stage, albumin‐bilirubin (ALBI) grade, and ALBI‐TNM (ALBI‐T) score using consecutive resected HCC cases. METHODS: Between 1998 and 2011, 273 consecutive patients who underwent primary and curative hepatectomy for HCC were identified. Among these 273 cases, 235 Child‐Pugh class A patients were enrolled in the present study. RESULTS: Correlation analysis showed that the value of linear predictor for ALBI grade was significantly correlated with ICG 15‐minute retention rates (r = 0.51, P < 0.0001). Survival analysis for both recurrence‐free survival (RFS) and overall survival (OS) showed there were significant differences between the two groups stratified by stage or ALBI‐T score (stage, RFS: P = 0.01, OS: P = 0.003; ALBI‐T, RFS: P < 0.0001, OS: P < 0.0001). In addition, Cox proportional hazard model identified ALBI‐T score was a significant predictor for both RFS and OS (RFS, P = 0.001; OS, P = 0.004). Furthermore, ALBI‐T score could predict perioperative risk in hepatectomy such as longer operation time and excessive intraoperative blood loss. CONCLUSIONS: This study showed a robust association of ALBI‐T score with postoperative HCC patient survival and perioperative risk in hepatectomy. ALBI‐T score can be used as a simple and powerful tool for assessing HCC patients with further study.