title: Albumin-bilirubin versus Child-Pugh score as a predictor of outcome after liver resection for hepatocellular carcinoma.
abstract: BACKGROUND
  The Child-Pugh (CP) score is used widely to assess liver function and predict postoperative outcomes in patients with hepatocellular carcinoma (HCC). Recently, the albumin-bilirubin (ALBI) score has been validated as a predictor of overall survival in these patients. This study aimed to compare the ability of the ALBI and CP scores to predict outcomes in patients with HCC after liver resection with curative intent.
  
  
  METHODS
  Consecutive patients who underwent liver resection with curative intent for HCC between January 2007 and July 2013 were included in this retrospective study. The performance of the ALBI score in predicting postoperative liver failure (PHLF) and long-term survival was compared with that of the CP score.
  
  
  RESULTS
  A total of 1242 patients were enrolled. Of these, 166 (13·4 per cent) experienced PHLF. The area under the receiver operating characteristic (ROC) curve of the ALBI score for predicting PHLF was greater than that of the CP score (0·723 versus 0·607; P < 0·001). Similar to findings for CP grade, the incidence and severity of PHLF increased with increasing ALBI grade. The ALBI grade stratified patients into at least two distinct overall survival cohorts (P < 0·001), whereas the CP grade did not. The ALBI grade also classified patients with CP grade A disease into two distinct overall survival cohorts (P < 0·001), and overall survival rates in the group with poorer survival were similar to those in the majority of patients with CP grade B disease. Both CP and ALBI scores had low power in predicting disease-free survival.
  
  
  CONCLUSIONS
  The ALBI grade predicted PHLF and overall survival in patients with HCC undergoing liver resection with curative intent more accurately than the CP grade.
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Centre, Nanning, China.
authors.forename: J-H
authors.initials: JH
authors.lastname: Zhong
authors.affiliation: Pharmaceutical College, Guangxi Medical University, Nanning, China.
authors.forename: Z-Y
authors.initials: ZY
authors.lastname: Su
authors.affiliation: Pharmaceutical College, Guangxi Medical University, Nanning, China.
authors.forename: J-F
authors.initials: JF
authors.lastname: Huang
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.
authors.forename: S-D
authors.initials: SD
authors.lastname: Lu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Centre, Nanning, China.
authors.forename: B-D
authors.initials: BD
authors.lastname: Xiang
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Centre, Nanning, China.
authors.forename: L
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Centre, Nanning, China.
authors.forename: L-N
authors.initials: LN
authors.lastname: Qi
authors.affiliation: Pharmaceutical College, Guangxi Medical University, Nanning, China.
authors.forename: B-N
authors.initials: BN
authors.lastname: Ou
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Centre, Nanning, China.
authors.forename: L-Q
authors.initials: LQ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis* / Q000209:etiology; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis*; D015996:Survival Rate
chemical_list: D012709:Serum Albumin; D001663:Bilirubin