title: Application of the albumin-bilirubin grade for predicting prognosis after curative resection of patients with early-stage hepatocellular carcinoma.
abstract: BACKGROUND
  Patients with Barcelona Clinic Liver Cancer (BCLC) 0+A are considered to have early-stage hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) grade is a significant predictor of overall survival (OS) for HCC. However, data are lacking to support its significance for patients with early-HCC.
  
  
  METHODS
  We recruited 318 patients with early-HCC who underwent curative resection between January 2012 and August 2013. The Kaplan-Meier method and log-rank tests were used to compare OS of patients with different ALBI grades. Cox regression analysis was applied to evaluate ALBI grade as an independent predictor of OS.
  
  
  RESULTS
  Early-HCC patients with ALBI grade II experienced significantly shorter OS (p<0.001) and higher death rates. In the Child-Pugh (C-P) grade-A group, patients with ALBI grade I had a more favorable prognosis than those with grade II (p<0.001), while the C-P grade did not distinguish patients with poor prognosis from the entire group. Cox regression analysis demonstrated that ALBI grade was the most significant independent predictor of OS, and the ALBI grade retained its clinical significance in low α-fetoprotein subgroup.
  
  
  CONCLUSIONS
  ALBI grade predicted OS in patients with early-HCC. Reclassification of C-P grade according to ALBI grade might improve the management of HCC.
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Xiao-Lu
authors: XL
authors: Ma
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Jia-Ye
authors: JY
authors: Zhou
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Xing-Hui
authors: XH
authors: Gao
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Lu
authors: L
authors: Tian
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Jiong
authors: J
authors: Wu
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Chun-Yan
authors: CY
authors: Zhang
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Yan
authors: Y
authors: Zhou
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Qian
authors: Q
authors: Dai
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Bei-Li
authors: BL
authors: Wang
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors: Bai-Shen
authors: BS
authors: Pan
authors: Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, PR China.
authors: Xin-Rong
authors: XR
authors: Yang
authors: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China. Electronic address: guo.wei@zs-hospital.sh.cn.
authors: Wei
authors: W
authors: Guo
mesh_terms: D000418:Albumins / Q000032:analysis*; D001663:Bilirubin / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000418:Albumins; D001663:Bilirubin
keywords: Albumin-bilirubin score; Barcelona Clinic Liver Cancer; Curative resection; Hepatocellular carcinoma; Overall survival