A multicenter comparison between Child Pugh and ALBI scores in patients treated with sorafenib for hepatocellular carcinoma

Edeline, J. et al. (2016) A multicenter comparison between Child Pugh and ALBI scores in patients treated with sorafenib for hepatocellular carcinoma. Liver International, 36(2), pp. 1821-1828. (doi: 10.1111/liv.13170) (PMID:27214151)

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Background & aims: The ALBI grade was proposed as an objective means to evaluate liver function in patients with Hepatocellular Carcinoma (HCC). ALBI grade 1 vs 2 were proposed as stratification factors within the Child Pugh (CP) A class. However, the original publication did not provide comparison with the sub-classification by points (5 to 15) within the CP classification. Methods: We retrospectively analyzed data from patients treated with sorafenib for HCC from 17 centers in United Kingdom and France. Overall survival (OS) was analyzed with the Kaplan-Meier method and a Cox regression model. Discriminatory abilities of the classifications were assessed with the log likelihood ratio, Harrell’s C statistics and Akaike information criterion. Results: Data from 1,019 patients were collected, of which 905 could be assessed for both scores. 92% of ALBI grade 1 were CP A5 while ALBI 2 included a broad range of CP scores of which 44% were CP A6. Median OS was 10.2, 7.0 and 3.6 months for CP scores A5, A6 and >A6, respectively (P<0.001), Hazard Ratio (HR)=1.60 (95%CI: 1.35-1.89, P<0.001) for A6 vs A5. Median OS was 10.9, 6.6 and 3.0 months for ALBI grade 1, 2 and 3, respectively (P<0.001), HR=1.68 (1.43-1.97, P<0.001) for grade 2 vs 1. Discriminatory abilities of CP and ALBI were similar in the CP A population, but better for CP in the overall population. Conclusions: Our findings support the use CP class A as an inclusion criterion, and ALBI as a stratification factor in trials of systemic therapy.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Evans, Professor Jeff
Authors: Edeline, J., Blanc, J.-F., Johnson, P., Campillo-Gimenez, B., Ross, P., Ma, Y. T., King, J., Hubner, R. A., Sumpter, K., Darby, S., Evans, J., Iwuji, C., Swinson, D., Collins, P., Patel, K., Muazzam, I., Palmer, D. H., and Meyer, T.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:Liver International
ISSN (Online):1478-3231
Published Online:23 May 2016
Copyright Holders:Copyright © 2016 Wiley
First Published:First published in Liver International 36(2):1821-1828
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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