Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, 90110, Thailand.
Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
J Gastrointest Cancer. 2022 Dec;53(4):1006-1013. doi: 10.1007/s12029-021-00743-6. Epub 2021 Nov 10.
We assessed the ability of the Child-Turcotte-Pugh score and the albumin-bilirubin grade to predict the outcomes of hepatocellular carcinoma (HCC) in patients treated with transarterial chemoembolization.
We retrospectively assessed 158 patients with HCC who underwent transarterial chemoembolization. The ability of the Child-Turcotte-Pugh score and the albumin-bilirubin grade to predict patient survival was assessed using the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate survival-predictive variables and the relationship between the obtained score and overall survival.
Child-Turcotte-Pugh A (n = 102 (64.6%)) patients showed better overall survival than Child-Turcotte-Pugh B (n = 56 (35.4%)) patients (log-rank P = 0.017), while no significant difference in the overall survival between albumin-bilirubin ≤ 1 (n = 37 (23.4%)) and albumin-bilirubin > 1 (n = 121 (76.6%)) was detected (log-rank P = 0.140). Multivariate analysis identified alcoholic liver disease (P = 0.029), tumor size > 5 cm (P = 0.004), and serum alpha-fetoprotein > 200 ng/mL (P < 0.001) as independent predictive factors of mortality risk. A higher Child-Turcotte-Pugh score was positively associated with decreased overall survival (P = 0.031); however, a higher albumin-bilirubin grade showed marginally significant association (P = 0.088).
The Child-Turcotte-Pugh score precisely categorized the outcomes of HCC in patients undergoing transarterial chemoembolization, and cirrhotic patients with Child-Turcotte-Pugh A will have a better overall survival than those with Child-Turcotte-Pugh B, regardless of HCC status. These results suggest that the Child-Turcotte-Pugh classification system is a more powerful tool to predict patient outcomes than the albumin-bilirubin grading system.
我们评估了Child-Turcotte-Pugh 评分和白蛋白-胆红素分级在接受经动脉化疗栓塞治疗的肝细胞癌（HCC）患者中的预后能力。
我们回顾性评估了 158 例接受经动脉化疗栓塞治疗的 HCC 患者。使用 Kaplan-Meier 方法评估 Child-Turcotte-Pugh 评分和白蛋白-胆红素分级对患者生存的预测能力。使用 Cox 比例风险模型评估生存预测变量以及获得的评分与总生存之间的关系。
Child-Turcotte-Pugh A（n=102（64.6%））患者的总生存率优于 Child-Turcotte-Pugh B（n=56（35.4%））患者（对数秩检验 P=0.017），而白蛋白-胆红素≤1（n=37（23.4%））和白蛋白-胆红素>1（n=121（76.6%））患者的总生存率无显著差异（对数秩检验 P=0.140）。多变量分析确定酒精性肝病（P=0.029）、肿瘤大小>5cm（P=0.004）和血清甲胎蛋白>200ng/ml（P<0.001）为死亡率的独立预测因素。较高的 Child-Turcotte-Pugh 评分与总生存率降低呈正相关（P=0.031）；然而，较高的白蛋白-胆红素分级显示出边缘显著的相关性（P=0.088）。
Child-Turcotte-Pugh 评分精确地对接受经动脉化疗栓塞治疗的 HCC 患者的预后进行分类，Child-Turcotte-Pugh A 的肝硬化患者的总生存率优于 Child-Turcotte-Pugh B 的患者，无论 HCC 状态如何。这些结果表明，Child-Turcotte-Pugh 分类系统是预测患者预后的更有效工具，优于白蛋白-胆红素分级系统。
