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Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade

SIMPLE SUMMARY: Ascites is a hallmark of advanced cirrhosis and often coexists in patients with hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) grade and EZ (easy)-ALBI grade are used to indicate the severity of liver dysfunction in HCC, but the predictive accuracy of these two models i...

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Autores principales: Liao, Jia-I, Ho, Shu-Yein, Liu, Po-Hong, Hsu, Chia-Yang, Huang, Yi-Hsiang, Su, Chien-Wei, Hou, Ming-Chih, Huo, Teh-Ia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913159/
https://www.ncbi.nlm.nih.gov/pubmed/36765711
http://dx.doi.org/10.3390/cancers15030753
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author Liao, Jia-I
Ho, Shu-Yein
Liu, Po-Hong
Hsu, Chia-Yang
Huang, Yi-Hsiang
Su, Chien-Wei
Hou, Ming-Chih
Huo, Teh-Ia
author_facet Liao, Jia-I
Ho, Shu-Yein
Liu, Po-Hong
Hsu, Chia-Yang
Huang, Yi-Hsiang
Su, Chien-Wei
Hou, Ming-Chih
Huo, Teh-Ia
author_sort Liao, Jia-I
collection PubMed
description SIMPLE SUMMARY: Ascites is a hallmark of advanced cirrhosis and often coexists in patients with hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) grade and EZ (easy)-ALBI grade are used to indicate the severity of liver dysfunction in HCC, but the predictive accuracy of these two models in HCC patients with ascites is unclear. We found that ascites is highly prevalent (22.5%) in HCC; higher ascites grade was associated with higher ALBI and EZ-ALBI scores and linked with decreased overall survival. In the Cox multivariate analysis, serum bilirubin level > 1.1 mg/dL, creatinine level ≥ 1.2 mg/dL, α-fetoprotein ≥ 20 ng/mL, total tumor volume > 100 cm(3), vascular invasion, distant metastasis, poor performance status, ALBI grade 2 and 3, EZ-ALBI grade 2 and 3, and non-curative treatments were independently associated with increased mortality in ascitic HCC patients. The ALBI and EZ-ALBI grade can adequately stratify overall survival in both the entire cohort and specifically in HCC patients with ascites. ABSTRACT: Patients with hepatocellular carcinoma (HCC) often have co-existing ascites, which is a hallmark of liver decompensation. The albumin-bilirubin (ALBI) grade and EZ (easy)-ALBI grade are used to assess liver functional reserve in HCC, but the predictive accuracy of these two models in HCC patients with ascites is unclear. We aimed to determine the prognostic role of ALBI and EZ-ALBI grades in these patients. A total of 4431 HCC patients were prospectively enrolled and retrospectively analyzed. Independent prognostic predictors were identified by the multivariate Cox proportional hazards model. Of all patients, 995 (22.5%) patients had ascites. Grade 1, 2, and 3 ascites were found in 16%, 4%, and 3% of them, respectively. A higher ascites grade was associated with higher ALBI and EZ-ALBI scores and linked with decreased overall survival. In the Cox multivariate analysis, serum bilirubin level > 1.1 mg/dL, creatinine level ≥ 1.2 mg/dL, α-fetoprotein ≥ 20 ng/mL, total tumor volume > 100 cm(3), vascular invasion, distant metastasis, poor performance status, ALBI grade 2 and 3, EZ-ALBI grade 2 and 3, and non-curative treatments were independently associated with increased mortality (all p < 0.05) among HCC patients with ascites. The ALBI and EZ-ALBI grade can adequately stratify overall survival in both the entire cohort and specifically in patients with ascites. Ascites is highly prevalent and independently predict patient survival in HCC. The ALBI and EZ-ALBI grade are feasible markers of liver dysfunction and can stratify long-term survival in HCC patients with ascites.
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spelling pubmed-99131592023-02-11 Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade Liao, Jia-I Ho, Shu-Yein Liu, Po-Hong Hsu, Chia-Yang Huang, Yi-Hsiang Su, Chien-Wei Hou, Ming-Chih Huo, Teh-Ia Cancers (Basel) Article SIMPLE SUMMARY: Ascites is a hallmark of advanced cirrhosis and often coexists in patients with hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) grade and EZ (easy)-ALBI grade are used to indicate the severity of liver dysfunction in HCC, but the predictive accuracy of these two models in HCC patients with ascites is unclear. We found that ascites is highly prevalent (22.5%) in HCC; higher ascites grade was associated with higher ALBI and EZ-ALBI scores and linked with decreased overall survival. In the Cox multivariate analysis, serum bilirubin level > 1.1 mg/dL, creatinine level ≥ 1.2 mg/dL, α-fetoprotein ≥ 20 ng/mL, total tumor volume > 100 cm(3), vascular invasion, distant metastasis, poor performance status, ALBI grade 2 and 3, EZ-ALBI grade 2 and 3, and non-curative treatments were independently associated with increased mortality in ascitic HCC patients. The ALBI and EZ-ALBI grade can adequately stratify overall survival in both the entire cohort and specifically in HCC patients with ascites. ABSTRACT: Patients with hepatocellular carcinoma (HCC) often have co-existing ascites, which is a hallmark of liver decompensation. The albumin-bilirubin (ALBI) grade and EZ (easy)-ALBI grade are used to assess liver functional reserve in HCC, but the predictive accuracy of these two models in HCC patients with ascites is unclear. We aimed to determine the prognostic role of ALBI and EZ-ALBI grades in these patients. A total of 4431 HCC patients were prospectively enrolled and retrospectively analyzed. Independent prognostic predictors were identified by the multivariate Cox proportional hazards model. Of all patients, 995 (22.5%) patients had ascites. Grade 1, 2, and 3 ascites were found in 16%, 4%, and 3% of them, respectively. A higher ascites grade was associated with higher ALBI and EZ-ALBI scores and linked with decreased overall survival. In the Cox multivariate analysis, serum bilirubin level > 1.1 mg/dL, creatinine level ≥ 1.2 mg/dL, α-fetoprotein ≥ 20 ng/mL, total tumor volume > 100 cm(3), vascular invasion, distant metastasis, poor performance status, ALBI grade 2 and 3, EZ-ALBI grade 2 and 3, and non-curative treatments were independently associated with increased mortality (all p < 0.05) among HCC patients with ascites. The ALBI and EZ-ALBI grade can adequately stratify overall survival in both the entire cohort and specifically in patients with ascites. Ascites is highly prevalent and independently predict patient survival in HCC. The ALBI and EZ-ALBI grade are feasible markers of liver dysfunction and can stratify long-term survival in HCC patients with ascites. MDPI 2023-01-25 /pmc/articles/PMC9913159/ /pubmed/36765711 http://dx.doi.org/10.3390/cancers15030753 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liao, Jia-I
Ho, Shu-Yein
Liu, Po-Hong
Hsu, Chia-Yang
Huang, Yi-Hsiang
Su, Chien-Wei
Hou, Ming-Chih
Huo, Teh-Ia
Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade
title Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade
title_full Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade
title_fullStr Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade
title_full_unstemmed Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade
title_short Prognostic Prediction for Patients with Hepatocellular Carcinoma and Ascites: Role of Albumin-Bilirubin (ALBI) Grade and Easy (EZ)-ALBI Grade
title_sort prognostic prediction for patients with hepatocellular carcinoma and ascites: role of albumin-bilirubin (albi) grade and easy (ez)-albi grade
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913159/
https://www.ncbi.nlm.nih.gov/pubmed/36765711
http://dx.doi.org/10.3390/cancers15030753
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