ALBI GRADE VS. CHILD-PUGH GRADE AS A GRADING SYSTEM FOR LIVER FUNCTION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA

초록

Background and Aims: The Albumin-Bilirubin (ALBI) grade has been proposed as a simple, objective method of assessing liver function. The prognostic performance of the ALBI grade in the patients with hepatocellular carcinoma (HCC) was investigated in this study. Methods: Total 2,099 patients with HCC of the three tertiary hospitals in Korea were analyzed retrospectively. The discriminative performance in survival analysis of the ALBI grade was compared with the Child-Pugh (C-P) grade in different stages or treatments. Results: The median follow up duration was 16.2 months (Range: 0–138.5). The median survival times were 49.7 months in C-P grade A (65.8%), 12.4 months in C-P grade B (25.5%), 4.2 months in C-P grade C (8.6%) ( p < 0.001, Harrell’s C 0.68, Somers’ D 0.36). The median survival times were 84.2 months in ALBI grade 1 (32.8%), 25.5 months in ALBI grade 2 (53.5%), 7.7 months in ALBI grade 3 (13.7%) ( p < 0.001,Harrell’s C 0.682, Somers’ D 0.364). In early UICC stages, the ALBI grade showed better discriminative performance than the C-P grade (Harrell’s C: 0.676 (C-P grade) vs. 0.703 (ALBI grade), Somers’ D: 0.353 (C-P grade) vs. 0.406 (ALBI grade)). In curative treatments, the ALBI grade showed better discriminative performance than the C-P grade (Harrell’s C: 0.624 (C-P grade) vs. 0.667 (ALBI grade), Somers’D: 0.248 (C-P grade) vs. 0.334 (ALBI grade)) Conclusions: The ALBI grad showed comparable discriminative performance in survival analysis and better distribution of the grades in HCC. It could be a good alternative grading system for liver function in patients with HCC.