Chih-Chieh Ko1,2, Shu-Yein Ho2,3, Po-Hong Liu2,4, Chia-Yang Hsu2,5, Cheng-Yuan Hsia2,6, Yi-Hsiang Huang1,2,6, Chien-Wei Su1,2, Hao-Jan Lei2,7, Rheun-Chuan Lee2,8, Ming-Chih Hou1,2, Teh-Ia Huo9,10. 1. Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 2. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC. 3. Division of Gastroenterology and Hepatology, Min-Sheng General Hospital, Taoyuan, Taiwan, ROC. 4. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. 5. VA Sierra Nevada Health Care System, Reno, NV, USA. 6. Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC. 7. Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 8. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 9. Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei, 11217, Taiwan, ROC. tihuo@vghtpe.gov.tw. 10. Institute of Pharmacology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC. tihuo@vghtpe.gov.tw.
Abstract
BACKGROUND: Albumin-bilirubin (ALBI) grade is used to evaluate the outcome of patients with hepatocellular carcinoma (HCC) which is often associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study aimed to investigate the clinical characteristics, outcome, and prognostic role of ALBI grade in dual HBV/HCV-related HCC. METHODS: A total 3341 HCC patients with viral etiology were prospectively enrolled and retrospectively analyzed. Multivariate Cox proportional hazards model was used to identify independent prognostic predictors. RESULTS: Of all patients, 2083 (62%), 1068 (32%), and 190 (6%) patients had HBV, HCV, and dual HBV/HCV infection, respectively. The mean age of HBV, HCV, and dual virus group was 60, 68, and 64 years (p < 0.001), respectively. There was no significant survival difference between HBV, HCV, and dual HBV/HCV-related HCC group (p = 0.712). Multivariate Cox analysis in dual HBV/HCV-related HCC showed that multiple tumors [hazard ratio (HR): 1.537, p = 0.044], tumor size >3 cm (HR 2.014, p = 0.044), total tumor volume (TTV) >50 cm3 (HR 3.050, p < 0.001), vascular invasion (HR 3.258, p < 0.001), performance status 2-4 (HR 2.232, p < 0.001), ALBI grade 2-3 (HR 2.177, p < 0.001), and BCLC stage B-D (HR 2.479, p < 0.001) were independent predictors of poor survival. CONCLUSIONS: Dual viral infection does not accelerate the development of HCC in HBV carriers. Patient survival is similar between dual HBV/HCV-related HCC and single HBV- or HCV-related HCC group. The ALBI grade is a robust prognostic model in dual virus-related HCC to discriminate patient long-term survival.
BACKGROUND: Albumin-bilirubin (ALBI) grade is used to evaluate the outcome of patients with hepatocellular carcinoma (HCC) which is often associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study aimed to investigate the clinical characteristics, outcome, and prognostic role of ALBI grade in dual HBV/HCV-related HCC. METHODS: A total 3341 HCC patients with viral etiology were prospectively enrolled and retrospectively analyzed. Multivariate Cox proportional hazards model was used to identify independent prognostic predictors. RESULTS: Of all patients, 2083 (62%), 1068 (32%), and 190 (6%) patients had HBV, HCV, and dual HBV/HCV infection, respectively. The mean age of HBV, HCV, and dual virus group was 60, 68, and 64 years (p < 0.001), respectively. There was no significant survival difference between HBV, HCV, and dual HBV/HCV-related HCC group (p = 0.712). Multivariate Cox analysis in dual HBV/HCV-related HCC showed that multiple tumors [hazard ratio (HR): 1.537, p = 0.044], tumor size >3 cm (HR 2.014, p = 0.044), total tumor volume (TTV) >50 cm3 (HR 3.050, p < 0.001), vascular invasion (HR 3.258, p < 0.001), performance status 2-4 (HR 2.232, p < 0.001), ALBI grade 2-3 (HR 2.177, p < 0.001), and BCLC stage B-D (HR 2.479, p < 0.001) were independent predictors of poor survival. CONCLUSIONS: Dual viral infection does not accelerate the development of HCC in HBV carriers. Patient survival is similar between dual HBV/HCV-related HCC and single HBV- or HCV-related HCC group. The ALBI grade is a robust prognostic model in dual virus-related HCC to discriminate patient long-term survival.
Authors: D S Chen; G C Kuo; J L Sung; M Y Lai; J C Sheu; P J Chen; P M Yang; H M Hsu; M H Chang; C J Chen Journal: J Infect Dis Date: 1990-10 Impact factor: 5.226
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Authors: Luciana Kikuchi; Claudia P Oliveira; Mario R Alvares-da-Silva; Claudia M Tani; Marcio A Diniz; Jose T Stefano; Aline L Chagas; Regiane S S M Alencar; Denise C P Vezozzo; Gilmar R Santos; Priscila B Campos; Venancio Af Alves; Vlad Ratziu; Flair J Carrilho Journal: Am J Clin Oncol Date: 2016-10 Impact factor: 2.339