白蛋白-胆红素等级在确定极早期肝细胞癌患者预后中的作用

StephenW

The role of albumin-bilirubin grade in determining the outcomes of patients with very early stage hepatocellular carcinoma
Chung-Yu Chang  1 , Cheng-Yi Wei, Ping-Hsien Chen, Ming-Chih Hou, Yee Chao, Gar-Yang Chau, Rheun-Chuan Lee, Yi-Hsiang Huang, Yu-Hui Su, Jaw-Ching Wu, Chien-Wei Su
Affiliations
Affiliation

    1
    Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC Division of Gastroenterology and Hepatology, Department of Medicine, West Garden Hospital, Taiwan, ROC Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC Department of Accounting, School of Business, Soochow University, Taipei, Taiwan, ROC Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Cancer Progression Research Center, National Yang-Ming University, Taipei, Taiwan, ROC Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

    PMID: 33433133 DOI: 10.1097/JCMA.0000000000000482

Abstract

Background: Patients with hepatocellular carcinoma (HCC) and with a single tumor <2 cm in size are classified as having Barcelona Clinic Liver Cancer (BCLC) stage 0 HCC. We aimed to investigate the role of the albumin-bilirubin (ALBI) grade in predicting outcomes in patients with BCLC stage 0 HCC.

Methods: We retrospectively enrolled patients with BCLC stage 0 HCC in Taipei Veterans General Hospital from 2007 to 2015. Prognostic factors were analyzed using a Cox proportional hazards model and propensity score matching (PSM) analysis.

Results: There were 420 patients enrolled, including 207 with ALBI grade 1, and 213 with ALBI grade 2 or 3. After a median follow-up of 60.0 months (interquartile range, 37.2-84.6 months), 179 patients died. The cumulative 5-year overall survival (OS) rates were 80.6% in patients with ALBI grade 1 and 53.7% in those with ALBI grade 2 or 3, respectively (p <0.001). Multivariate analysis showed that age >65 years, negative hepatitis B surface in serum, creatinine >1.0 mg/dL, platelet count ≤105/mm3, tumor size >1.5 cm, non-surgical resection (SR) therapy, and higher ALBI grade were independent risk factors related to poor OS. Patients who underwent SR had a better OS and recurrence-free survival than those who received radiofrequency ablation, which was confirmed by a multivariate analysis and PSM analysis.

Conclusion: The ALBI grade can determine OS for patients with BCLC stage 0 HCC. SR can also provide a better outcome than non-surgical treatment.

Copyright © 2021 by Lippincott Williams & Wilkins, Inc.

StephenW

白蛋白-胆红素等级在确定极早期肝细胞癌患者预后中的作用
张忠禹1，魏成义，陈炳贤，侯明治，赵怡，周嘉扬，李R全，黄以祥，苏玉辉，吴乔清，简苏伟
隶属关系
联系

    1个
    台湾台北市台北荣民总医院消化内科及肝病科，台湾台北荣民总医院中华民国保健及服务中心，台湾台北荣民总医院内镜诊断与治疗中心，台湾台北，国立阳明大学医学院中华民国医学院，台湾台北市，台湾西花园医院医学部中华民国消化内科，中华民国台北荣民总医院肿瘤科台湾台北市荣民总医院外科中华民国外科普通外科，台湾台北市荣民总医院放射科中华民国阳明大学医学院中华民国临床医学研究所台湾台北，东吴大学商学院中华民国会计系，台湾台北，中华民国台北市立医学研究系台湾台北市安斯总医院，国立阳明大学中华民国癌症进展研究中心，台湾台北，中华民国台北荣民总医院医学部中华民国医院病房。

    PMID：33433133 DOI：10.1097 / JCMA.0000000000000482

抽象

背景：患有肝细胞癌（HCC）且单个肿瘤大小小于2 cm的患者被归类为巴塞罗那临床肝癌（BCLC）0期HCC。我们旨在调查白蛋白-胆红素（ALBI）等级在预测BCLC 0级肝癌患者预后中的作用。

方法：我们回顾性分析2007年至2015年在台北荣民总医院进行的BCLC 0级肝癌患者的临床资料。采用Cox比例风险模型和倾向评分匹配（PSM）分析了预后因素。

结果：招募了420例患者，其中207例为ALBI 1级，而213例为ALBI 2级或3级。在中位随访60.0个月（四分位数间距为37.2-84.6个月）后，有179例患者死亡。 ALBI 1级患者的5年累积总生存率（OS）分别为80.6％，ALBI 2级或3级患者为53.7％（p <0.001）。多因素分析显示，年龄> 65岁，血清乙型肝炎表面阴性，肌酐> 1.0 mg / dL，血小板计数≤105/ mm3，肿瘤大小> 1.5 cm，非手术切除（SR）治疗和ALBI等级较高与不良OS相关的独立风险因素。多变量分析和PSM分析证实，接受SR的患者比接受射频消融的患者具有更好的OS和无复发生存率。

结论：ALBI等级可以确定BCLC 0期HCC患者的OS。 SR还可以提供比非手术治疗更好的结果。

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