Applicability of albumin-bilirubin-based Japan integrated staging score in hepatitis B-associated hepatocellular carcinoma
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AbstractBackground and Aim: The Japan Integrated Staging (JIS) for hepatocellular carcinoma (HCC) has been extensively studied in hepatitis virus C-endemic Japanese population but seldom evaluated outside Japan, while albumin-bilirubin (ALBI)-based JIS (ALBI-T) has never been externally validated. We evaluate the prognostic significance of the ALBI-T score among Chinese patients with hepatitis virus B (HBV)-related HCC, and to explore its potential therapeutic application in selecting patients for appropriate treatments in addition to the Barcelona Clinic Liver Cancer (BCLC) recommendation.
Methods: A cohort of 1222 HBV-associated HCC patients was evaluated to compare the prognostic performance of JIS and ALBI-T scores by homogeneity likelihood chi-square and corrected Akaike information criterion. In the subgroup analysis of each BCLC stage, Kaplan–Meier method and log-rank statistics were used to compare overall survival of patients undergoing different treatment options.
Results: The ALBI-T score showed better prognostic performance than the JIS score, which were indicated by homogeneity likelihood chi-squares (ALBI-T 580.12 vs JIS 536.35) and Akaike information criteria (ALBI-T 9836.57 vs JIS 9880.23). Treatment options significantly influenced prognosis among patients of the same BCLC stage. With the use of ALBI-T score 4 as the cutoff, the current study identified that a portion of patients (14.7%, 25.2% and 28.6% of BCLC stage B, C and D, respectively) undergoing unnecessary therapy without survival advantage.
Conclusions: The ALBI-T score is applicable to Chinese patients with HBV-related HCC to provide reasonable prognostic information as well as potentially helping clinicians to avoid offering non-beneficial aggressive treatments.
All Author(s) ListChan A.W.H., Chong C.C.N., Mo F.K.F., Wong J., Yeo W., Johnson P.J., Yu S., Lai P.B.S., Chan A.T.C., To K.-F., Chan S.L.
Journal nameJournal of Gastroenterology and Hepatology
Volume Number31
Issue Number10
PublisherBlackwell Publishing Inc.
Place of PublicationUnited Kingdom
Pages1766 - 1772
LanguagesEnglish-United Kingdom
KeywordsBarcelona Clinic Liver Cancer (BCLC), liver neoplasm, staging, survival

Last updated on 2020-12-07 at 02:46