Atsushi Hiraoka1, Takashi Kumada2, Kunihiko Tsuji3, Koichi Takaguchi4, Ei Itobayashi5, Kazuya Kariyama6, Hironori Ochi7, Kazuto Tajiri8, Masashi Hirooka9, Noritomo Shimada10, Toru Ishikawa11, Yoshihiko Tachi12, Toshifumi Tada2, Hidenori Toyoda2, Kazuhiro Nouso6, Kouji Joko7, Yoichi Hiasa9, Kojiro Michitaka1, Masatoshi Kudo13. 1. Gastroenterology Center, Ehime Prefectural Central Hospital, Ehime, Japan. 2. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan. 3. Gastroenterology Center, Teine Keijinkai Hospital, Sapporo, Japan. 4. Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan. 5. Department of Gastroenterology, Asahi General Hospital, Asahi, Japan. 6. Department of Gastroenterology, Okayama City Hospital, Okayama, Japan. 7. Hepato-Biliary Center, Matsuyama Red Cross Hospital, Matsuyama, Japan. 8. Department of Gastroenterology, Toyama University Hospital, Toyama, Japan. 9. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan. 10. Division of Gastroenterology and Hepatology, Ootakanomori Hospital, Kashiwa, Japan. 11. Department of Gastroenterology, Saiseikai Niigata Daini Hospital, Niigata, Japan. 12. Department of Gastroenterology, Komaki City Hospital, Komaki, Japan. 13. Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osaka, Japan.
Abstract
BACKGROUND/AIM: The frequency of hepatocellular carcinoma (HCC) in patients with good hepatic reserve function has been increasing in Japan along with the progression of antiviral therapies and aging of the society. We evaluated the usefulness of modified albumin-bilirubin (ALBI) grade as a tool for assessment of hepatic reserve function. MATERIALS/ METHODS: We enrolled 6,649 naïve HCC patients treated from 2000 to 2017 and divided them into training (Ehime Prefecture group: E group, n = 2,357) and validation (validation group: V group, n = 4,292) cohorts. Child-Pugh classification and ALBI and modified ALBI (mALBI) grading were compared using with Japan Integrated Staging (JIS), ALBI-TNM (ALBI-T), and mALBI-T scores, which were calculated based on TNM stage and each assessment tool, retrospectively. RESULTS: In the E group, Akaike's Information Criterion (AIC) and c-index values for mALBI-T (13,725.2/0.744) were better as compared to those of ALBI-T (13,772.6/0.733) and JIS score (13,874.7/0.720), with similar results observed in the V group (mALBI-T: 27,727.4/0.760; ALBI-T: 27,817.8/0.750; JIS: 27,807.5/0.748). Although there were some significant differences between the groups with regard to clinical background factors (age, etiology, tumor size, tumor number, treatment modalities), for all patients the AIC and c-index values of mALBI-T (45,327.1/0.755) were also better than those of ALBI-T (45,467.7/0.744) and JIS scores (45,555.8/0.739), indicating its superior stratification ability and prognostic predictive value in patients with HCC. CONCLUSION: The detailed stratification ability of mALBI grade for hepatic reserve function is suitable for the recent trend of HCC patients, while mALBI-T may provide a more accurate predictive value than existing total staging scoring systems.
BACKGROUND/AIM: The frequency of hepatocellular carcinoma (HCC) in patients with good hepatic reserve function has been increasing in Japan along with the progression of antiviral therapies and aging of the society. We evaluated the usefulness of modified albumin-bilirubin (ALBI) grade as a tool for assessment of hepatic reserve function. MATERIALS/ METHODS: We enrolled 6,649 naïve HCC patients treated from 2000 to 2017 and divided them into training (Ehime Prefecture group: E group, n = 2,357) and validation (validation group: V group, n = 4,292) cohorts. Child-Pugh classification and ALBI and modified ALBI (mALBI) grading were compared using with Japan Integrated Staging (JIS), ALBI-TNM (ALBI-T), and mALBI-T scores, which were calculated based on TNM stage and each assessment tool, retrospectively. RESULTS: In the E group, Akaike's Information Criterion (AIC) and c-index values for mALBI-T (13,725.2/0.744) were better as compared to those of ALBI-T (13,772.6/0.733) and JIS score (13,874.7/0.720), with similar results observed in the V group (mALBI-T: 27,727.4/0.760; ALBI-T: 27,817.8/0.750; JIS: 27,807.5/0.748). Although there were some significant differences between the groups with regard to clinical background factors (age, etiology, tumor size, tumor number, treatment modalities), for all patients the AIC and c-index values of mALBI-T (45,327.1/0.755) were also better than those of ALBI-T (45,467.7/0.744) and JIS scores (45,555.8/0.739), indicating its superior stratification ability and prognostic predictive value in patients with HCC. CONCLUSION: The detailed stratification ability of mALBI grade for hepatic reserve function is suitable for the recent trend of HCC patients, while mALBI-T may provide a more accurate predictive value than existing total staging scoring systems.
Authors: Gauri Mishra; Ammar Majeed; Anouk Dev; Guy D Eslick; David J Pinato; Hirofumi Izumoto; Atsushi Hiraoka; Teh-Ia Huo; Po-Hong Liu; Philip J Johnson; Stuart K Roberts Journal: J Gastrointest Cancer Date: 2022-05-30
Authors: Osman Öcal; Juozas Kupčinskas; Egidijus Morkunas; Holger Amthauer; Kerstin Schütte; Peter Malfertheiner; Heinz Josef Klümpen; Christian Sengel; Julia Benckert; Ricarda Seidensticker; Bruno Sangro; Moritz Wildgruber; Maciej Pech; Peter Bartenstein; Jens Ricke; Max Seidensticker Journal: EJNMMI Res Date: 2021-06-02 Impact factor: 3.138