The EZ-ALBI score as a prognostic tool for outcomes after resection of small hepatocellular carcinoma (≤3 cm).

PURPOSE

Liver function is a key prognostic factor in patients with hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) score is an objective method to assess liver function severity, but its calculation is complex and challenging to implement in clinical practice. This study evaluated the prognostic utility of the EZ-ALBI score, which uses a simpler and more accessible calculation method, in patients undergoing resection for small HCC (≤3 cm).

METHODS

The study included 1161 patients who underwent hepatectomy for small HCC. Data from these patients were analyzed, with 837 patients in dataset A and 324 in dataset B, considering the differences in surgical procedures between facilities.

RESULTS

There was a strong correlation between the ALBI and EZ-ALBI scores across all patients, with a correlation coefficient of 0.974 (p < 0.0001). Comparison between the EZ-ALBI Grade 1 (n = 647) and Grade 2 (n = 514) groups showed that Grade 2 had significantly poorer liver function, shorter operative time, and higher rates of postoperative complications. In dataset A, patients in the EZ-ALBI Grade 2 group had significantly worse overall survival than those in Grade 1 (p < 0.0001). Similar trends were observed in dataset B, where Grade 2 was associated with significantly worse disease-free survival and overall survival. Univariate and multivariate analyses identified the EZ-ALBI score as an independent prognostic factor for OS in both datasets, with Grade 1 patients showing a better prognosis.

CONCLUSION

The EZ-ALBI score is a valuable prognostic tool for assessing outcomes after resection of small HCC.