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.
Br J Surg. 2016 May;103(6):725-734. doi: 10.1002/bjs.10095. Epub 2016 Mar 23.
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.
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.
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.
The ALBI grade predicted PHLF and overall survival in patients with HCC undergoing liver resection with curative intent more accurately than the CP grade.
Child-Pugh（CP）评分被广泛用于评估肝癌（HCC）患者的肝功能并预测术后结果。最近，白蛋白-胆红素（ALBI）评分已被验证为这些患者总生存率的预测指标。本研究旨在比较 ALBI 和 CP 评分在预测具有根治性肝切除意向的 HCC 患者术后结局的能力。
本回顾性研究纳入了 2007 年 1 月至 2013 年 7 月期间接受根治性肝切除的 HCC 连续患者。比较了 ALBI 评分在预测术后肝衰竭（PHLF）和长期生存方面的表现与 CP 评分的表现。
共纳入 1242 例患者，其中 166 例（13.4%）发生 PHLF。ALBI 评分预测 PHLF 的受试者工作特征曲线（ROC）下面积大于 CP 评分（0.723 比 0.607；P<0.001）。与 CP 分级相似，PHLF 的发生率和严重程度随 ALBI 分级的增加而增加。ALBI 分级将患者分为至少两个不同的总体生存队列（P<0.001），而 CP 分级则不然。ALBI 分级还将 CP 分级 A 疾病的患者分为两个不同的总体生存队列（P<0.001），且生存率较差组的总体生存率与 CP 分级 B 疾病的大多数患者相似。CP 和 ALBI 评分在预测无病生存率方面的效能均较低。
ALBI 分级比 CP 分级更准确地预测了接受根治性肝切除术的 HCC 患者的 PHLF 和总体生存率。
