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Document type:
Article; Journal Article
Author(s):
Kornberg, Arno; Witt, Ulrike; Schernhammer, Martina; Kornberg, Jennifer; Müller, Katharina; Friess, Helmut; Thrum, Katharina
Title:
The role of preoperative albumin-bilirubin grade for oncological risk stratification in liver transplant patients with hepatocellular carcinoma.
Abstract:
BACKGROUND AND OBJECTIVES: Albumin-bilirubin (ALBI) score was shown to correlate with liver function and tumor recurrence after hepatectomy for hepatocellular carcinoma (HCC). The aim of this study was to assess the prognostic value of ALBI grade in liver transplantation (LT) patients with HCC. METHODS: Pre-LT available independent predictors of recurrence-free survival (RFS) and microvascular tumor invasion (MVI) were determined in 123 patients with HCC. RESULTS: Posttransplant HCC recurrence rates were 10.5%, 15.9%, and 68.2% in ALBI grade 1, 2, and 3, respectively (P < .001). Along with serum α-fetoprotein (AFP) and C-reactive protein (CRP) levels, ALBI grades 1 or 2 was identified as an independent predictor of RFS (hazard ratio, 3.52; 95% confidence interval [CI], 1.577-7.842; P = .002). Furthermore, ALBI grade 3 proved to be the strongest indicator of MVI (odds ratio, 11.59; 95% CI, 3.412-39.381; P < .001). A novel oncological risk score-based on AFP, CRP, and ALBI grade provided the best discriminative capacity (c-statistic 0.806) in selecting liver recipients with low oncological risk profile. CONCLUSION: Preoperative ALBI grade seems to be valuable for refinement of oncological risk stratification at LT for HCC.
Journal title abbreviation:
J Surg Oncol
Year:
2019
Journal volume:
120
Journal issue:
7
Pages contribution:
1126-1136
Fulltext / DOI:
doi:10.1002/jso.25721
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/31578753
Print-ISSN:
0022-4790
TUM Institution:
Chirurgische Klinik und Poliklinik
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