Dynamic Change of Albumin-Bilirubin Score Is Good Predictive Parameter for Prognosis in Chronic Hepatitis C-hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization

Po-Ting Lin; Wei Teng; Wen-Juei Jeng; Wei-Ting Chen; Yi-Chung Hsieh; Chien-Hao Huang; Kar-Wai Lui; Chen-Fu Hung; Ching-Ting Wang; Pei-Mei Chai; Chen-Chun Lin; Chun-Yen Lin; Shi-Ming Lin; I-Shyan Sheen

doi:10.3390/diagnostics12030665

Dynamic Change of Albumin-Bilirubin Score Is Good Predictive Parameter for Prognosis in Chronic Hepatitis C-hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization

Diagnostics (Basel). 2022 Mar 9;12(3):665. doi: 10.3390/diagnostics12030665.

Authors

Po-Ting Lin^{1

2}, Wei Teng^{1

2

3}, Wen-Juei Jeng^{1

2

3

4}, Wei-Ting Chen^{1

2}, Yi-Chung Hsieh^{1

2}, Chien-Hao Huang^{1

2}, Kar-Wai Lui^{2

5}, Chen-Fu Hung^{2

6}, Ching-Ting Wang^{2

7}, Pei-Mei Chai^{2

7}, Chen-Chun Lin^{1

2}, Chun-Yen Lin^{1

2}, Shi-Ming Lin^{1

5}, I-Shyan Sheen^{1

5}

Affiliations

¹ Department of Gastroenterology and Hepatology, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
³ Institute of Clinical Medicine, National Yang-Ming University, Taipei City 11265, Taiwan.
⁴ School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
⁵ Department of Radiology, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
⁶ Department of Radiology, Tucheng Composite Municipal Hospital, New Taipei City 236, Taiwan.
⁷ Department of Nursing, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

Abstract

Background and Aims: The Albumin-Bilirubin (ALBI) grade is a good index for liver function evaluation and is also associated with the outcomes of hepatocellular carcinoma patients receiving TACE. However, the correlation between the dynamic change to the ALBI score and clinical outcome is seldom discussed. Therefore, this study aimed to investigate the application of ALBI grade and dynamic change of ALBI grade (delta ALBI grade) after first TACE for prognosis prediction in HCC patients with chronic hepatitis C infection. Method: From January 2005 to December 2015, newly diagnosed naive chronic hepatitis C-hepatocellular carcinoma (CHC-HCC) patients who were treated with TACE as the initial treatment at the Chang Gung Memorial Hospital, Linkou Medical Center, were retrospectively recruited. The pre-treatment host factors, tumor status and noninvasive markers were collected. The Cox regression model was used to identify independent predictors of overall survival and tumor recurrence. Results: Among 613 treatment-naive CHC-HCC patients, 430 patients died after repeated TACE during a median follow-up of 26.9 months. Complete remission after repeated TACE occurred in 46.2% patients, and 208 patients (33.9%) had tumor recurrence, with a median recurrence-free interval of 8.5 months. In Cox regression analysis, ALBI grade II/III (aHR: 1.088, p = 0.035) and increased delta ALBI grade (aHR: 1.456, p = 0.029) were independent predictive factors for tumor recurrence. Furthermore, ALBI grade II/III (aHR: 1.451, p = 0.005) and increased delta ALBI grade during treatment (aHR: 1.436, p = 0.006) were predictive factors for mortality, while achieving complete response after repeated TACE (aHR: 0.373, p < 0.001) and anti-viral therapy (aHR: 0.580, p = 0.002) were protective factors for mortality. Conclusion: Both ALBI and delta ALBI grade are independent parameters to predict survival and tumor recurrence of CHC-HCC patients receiving TACE treatment.

Keywords: albumin; alpha-fetoprotein; bilirubin; hepatitis; hepatocellular carcinoma; liver; survival.