A multicentre comparison between Child Pugh and Albumin‐Bilirubin scores in patients treated with sorafenib for Hepatocellular Carcinoma



Edeline, J, Blanc, J-F, Johnson, P ORCID: 0000-0003-1404-0209, Campillo-Gimenez, B, Ross, P, Ma, YT, King, J, Hubner, RA, Sumpter, K, Darby, S
et al (show 8 more authors) (2016) A multicentre comparison between Child Pugh and Albumin‐Bilirubin scores in patients treated with sorafenib for Hepatocellular Carcinoma. Liver international : official journal of the International Association for the Study of the Liver, 36 (12). 1821 - 1828.

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ALBI Child HCC sorafenib Liver Int Revision Final.docx - Accepted Version

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Abstract

The Albumin-Bilirubin (ALBI) grade was proposed as an objective means to evaluate liver function in patients with Hepatocellular Carcinoma (HCC). ALBI grade 1 vs 2 were proposed as stratification factors within the Child Pugh (CP) A class. However, the original publication did not provide comparison with the subclassification by points (5-15) within the CP classification.We retrospectively analysed data from patients treated with sorafenib for HCC from 17 centres in United Kingdom and France. Overall survival (OS) was analysed using the Kaplan-Meier method and a Cox regression model. Discriminatory abilities of the classifications were assessed with the log likelihood ratio, Harrell's C statistics and Akaike information criterion.Data from 1019 patients were collected, of which 905 could be assessed for both scores. 92% of ALBI grade 1 were CP A5 while ALBI 2 included a broad range of CP scores of which 44% were CP A6. Median OS was 10.2, 7.0 and 3.6 months for CP scores A5, A6 and >A6, respectively (P < 0.001), Hazard Ratio (HR) = 1.60 (95%CI: 1.35-1.89, P < 0.001) for A6 vs A5. Median OS was 10.9, 6.6 and 3.0 months for ALBI grade 1, 2 and 3, respectively (P < 0.001), HR = 1.68 (1.43-1.97, P < 0.001) for grade 2 vs 1. Discriminatory abilities of CP and ALBI were similar in the CP A population, but better for CP in the overall population.Our findings support the use CP class A as an inclusion criterion, and ALBI as a stratification factor in trials of systemic therapy.

Item Type: Article
Uncontrolled Keywords: Albumin, bilirubin, cirrhosis, liver function, prognosis
Depositing User: Symplectic Admin
Date Deposited: 17 Jan 2017 08:52
Last Modified: 16 Sep 2022 12:42
DOI: 10.1111/liv.13170
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3002919