Julien Edeline1, Jean-Frédéric Blanc2, Philip Johnson3,4, Boris Campillo-Gimenez1, Paul Ross5, Yuk Ting Ma6,7, Judy King8, Richard A Hubner9, Kate Sumpter10, Suzanne Darby11, Jeff Evans12, Chinenye Iwuji13, Daniel Swinson14, Peter Collins15, Kinnari Patel16, Iqtedar Muazzam17, Daniel H Palmer3,4, Tim Meyer8,18. 1. Centre Eugène Marquis, Rennes, France. 2. Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France. 3. University of Liverpool, Liverpool, UK. 4. Clatterbridge Cancer Centre, Liverpool, UK. 5. King's College Hospital NHS Foundation Trust, London, UK. 6. University of Birmingham, Birmingham, UK. 7. University Hospital Birmingham NHS Foundation Trust, Birmingham, UK. 8. Department of Oncology, Royal Free London NHS Foundation Trust, London, UK. 9. The Christie NHS Foundation Trust, Manchester, UK. 10. The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK. 11. Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. 12. University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK. 13. Leicester Royal Infirmary, Leicester, UK. 14. Leeds Teaching Hospitals NHS Trust, Leeds, UK. 15. University Hospitals Bristol NHS Foundation Trust, Bristol, UK. 16. Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 17. Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK. 18. UCL Cancer Institute, London, UK.
Abstract
BACKGROUND & AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Our findings support the use CP class A as an inclusion criterion, and ALBI as a stratification factor in trials of systemic therapy.
BACKGROUND & AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Our findings support the use CP class A as an inclusion criterion, and ALBI as a stratification factor in trials of systemic therapy.
Authors: Krithika Suresh; Dawn Owen; Latifa Bazzi; William Jackson; Randall K Ten Haken; Kyle Cuneo; Mary Feng; Theodore S Lawrence; Matthew J Schipper Journal: Int J Radiat Oncol Biol Phys Date: 2017-09-22 Impact factor: 7.038
Authors: Homan Mohammadi; Yazan Abuodeh; William Jin; Jessica Frakes; Mark Friedman; Benjamin Biebel; Junsung Choi; Ghassan El-Haddad; Bela Kis; Jennifer Sweeney; Sarah Hoffe Journal: J Gastrointest Oncol Date: 2018-10