title: Usefulness of albumin-bilirubin grade for evaluation of prognosis of 2584 Japanese patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  The Child-Pugh classification has some non-objective factors, with chronic hepatitis indistinguishable from early liver cirrhosis in Child-Pugh A. We retrospectively evaluated the efficacy of albumin-bilirubin (ALBI) grade, which has been proposed as a new classification for hepatic function, for grading hepatocellular carcinoma (HCC) patients based on hepatic function and predicting their prognosis.
  
  
  METHODS
  From 2000 to 2014, 2584 naïve HCC [69.0 ± 9.8 years old, 1850 men, 734 female, Child-Pugh class A:B:C = 1871:558:155] were enrolled. TNM staging was determined using the classification of the Liver Cancer Study Group of Japan and ALBI grade, instead of Child-Pugh classification (ALBI with TNM score: ALBI-T score) (Table 1), and is similar to the Japan Integrated Staging (JIS) score. We retrospectively compared ALBI-T and JIS scores in these patients.
  
  
  RESULTS
  Of patients classified as Child-Pugh A (n = 1871), 1285 with 5 points were divided into 858 with ALBI grade 1 and 427 with grade 2, while 586 with 6 points were divided into 53 with grade 1 and 533 with grade 2. The ratio of ALBI grade 2 patients with a Child-Pugh score of 6 points (91.0%) was similar to that of those with 7 points (91.8%). Patients with a lower ALBI-T score (0-5 points) showed a better median survival time than those with a corresponding lower JIS score [137.7:83.2:53.4:27.4:5.0:1.4 vs 97.6:74.9:39.7:15.0:4.0:1.0 months].
  
  
  CONCLUSIONS
  Albumin-bilirubin grade was found to be superior for distinguishing patients with better hepatic function. ALBI-T scoring may be a better total prognostic scoring system for predicting survival of Japanese patients with HCC.
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraoka
authors.affiliation: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.affiliation: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.affiliation: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tada
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Hidetaro
authors.initials: H
authors.lastname: Ueki
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Kaneto
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Aibiki
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Okudaira
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kawakami
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Hiroka
authors.initials: H
authors.lastname: Yamago
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Suga
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Hideomi
authors.initials: H
authors.lastname: Tomida
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Azemoto
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Mori
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Miyata
authors.affiliation: Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ninomiya
authors.affiliation: Department of Surgery, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawasaki
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D000075462:Serum Albumin, Human; D013997:Time Factors
chemical_list: C422455:ALB protein, human; D014408:Biomarkers, Tumor; D012709:Serum Albumin; D001663:Bilirubin; D000075462:Serum Albumin, Human
keywords: ALBI grade; JIS score; hepatocellular carcinoma; prognosis; scoring system