Kazuya Kariyama1, Kazuhiro Nouso1, Atsushi Hiraoka2, Akiko Wakuta1, Ayano Oonishi1, Teiji Kuzuya3, Hidenori Toyoda4, Toshifumi Tada5, Kunihiko Tsuji6, Ei Itobayashi7, Toru Ishikawa8, Koichi Takaguchi9, Akemi Tsutsui9, Noritomo Shimada10, Masatoshi Kudo11, Takashi Kumada4. 1. Department of Gastroenterology and Liver Disease Center, Okayama City Hospital, Okayama, Japan. 2. Gastroenterology Center, Ehime Prefectural Central Hospital, Ehime, Japan. 3. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 4. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan. 5. Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan. 6. Center of Gastroenterology, Teine Keijinkai Hospital, Hokkaido, Japan. 7. Department of Gastroenterology, Asahi General Hospital, Chiba, Japan. 8. Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan. 9. Department of Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan. 10. Department of Gastroenterology and Hepatology, Otakanomori Hospital, Chiba, Japan. 11. Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
Abstract
INTRODUCTION: The ALBI score is acknowledged as the gold standard for the assessment of liver function in patients with hepatocellular carcinoma (HCC). Unlike the Child-Pugh score, the ALBI score uses only objective parameters, albumin (Alb) and total bilirubin (T.Bil), enabling a better evaluation. However, the complex calculation of the ALBI score limits its applicability. Therefore, we developed a simplified ALBI score, based on data from a large-scale HCC database. We used the data of 5,249 naïve HCC cases registered in eight collaborating hospitals. METHODS: We developed a new score, the EZ (Easy)-ALBI score, based on regression coefficients of Alb and T.Bil for survival risk in a multivariate Cox proportional hazard model. We also developed the EZ-ALBI grade and EZ-ALBI-T grade as alternative options for the ALBI grade and ALBI-T grade and evaluated their stratifying ability. RESULTS: The equation used to calculate the EZ-ALBI score was simple {[T.Bil (mg/dL)] - [9 × Alb (g/dL)]}; this value highly correlated with the ALBI score (correlation coefficient, 0.981; p < 0.0001). The correlation was preserved across different Barcelona clinic liver cancer grade scores (regression coefficient, 0.93-0.98) and across different hospitals (regression coefficient, 0.98-0.99), indicating good generalizability. Although a good agreement was observed between ALBI and EZ-ALBI, discrepancies were observed in patients with poor liver function (T.Bil, ≥3 mg/dL; regression coefficient, 0.877). The stratifying ability of EZ-ALBI grade and EZ-ALBI-T grade were good and their Akaike's information criterion values (35,897 and 34,812, respectively) were comparable with those of ALBI grade and ALBI-T grade (35,914 and 34,816, respectively). CONCLUSIONS: The EZ-ALBI score, EZ-ALBI grade, and EZ-ALBI-T grade are useful, simple scores, which might replace the conventional ALBI score in the future.
INTRODUCTION: The ALBI score is acknowledged as the gold standard for the assessment of liver function in patients with hepatocellular carcinoma (HCC). Unlike the Child-Pugh score, the ALBI score uses only objective parameters, albumin (Alb) and total bilirubin (T.Bil), enabling a better evaluation. However, the complex calculation of the ALBI score limits its applicability. Therefore, we developed a simplified ALBI score, based on data from a large-scale HCC database. We used the data of 5,249 naïve HCC cases registered in eight collaborating hospitals. METHODS: We developed a new score, the EZ (Easy)-ALBI score, based on regression coefficients of Alb and T.Bil for survival risk in a multivariate Cox proportional hazard model. We also developed the EZ-ALBI grade and EZ-ALBI-T grade as alternative options for the ALBI grade and ALBI-T grade and evaluated their stratifying ability. RESULTS: The equation used to calculate the EZ-ALBI score was simple {[T.Bil (mg/dL)] - [9 × Alb (g/dL)]}; this value highly correlated with the ALBI score (correlation coefficient, 0.981; p < 0.0001). The correlation was preserved across different Barcelona clinic liver cancer grade scores (regression coefficient, 0.93-0.98) and across different hospitals (regression coefficient, 0.98-0.99), indicating good generalizability. Although a good agreement was observed between ALBI and EZ-ALBI, discrepancies were observed in patients with poor liver function (T.Bil, ≥3 mg/dL; regression coefficient, 0.877). The stratifying ability of EZ-ALBI grade and EZ-ALBI-T grade were good and their Akaike's information criterion values (35,897 and 34,812, respectively) were comparable with those of ALBI grade and ALBI-T grade (35,914 and 34,816, respectively). CONCLUSIONS: The EZ-ALBI score, EZ-ALBI grade, and EZ-ALBI-T grade are useful, simple scores, which might replace the conventional ALBI score in the future.
Authors: Philip J Johnson; Sarah Berhane; Chiaki Kagebayashi; Shinji Satomura; Mabel Teng; Helen L Reeves; James O'Beirne; Richard Fox; Anna Skowronska; Daniel Palmer; Winnie Yeo; Frankie Mo; Paul Lai; Mercedes Iñarrairaegui; Stephen L Chan; Bruno Sangro; Rebecca Miksad; Toshifumi Tada; Takashi Kumada; Hidenori Toyoda Journal: J Clin Oncol Date: 2014-12-15 Impact factor: 44.544
Authors: Andreas Schmid; Miriam Arians; Thomas Karrasch; Jörn Pons-Kühnemann; Andreas Schäffler; Martin Roderfeld; Elke Roeb Journal: J Clin Med Date: 2022-03-22 Impact factor: 4.241