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A multicentre comparison between Child Pugh and Albumin-Bilirubin scores in patients treated with sorafenib for Hepatocellular Carcinoma

Lookup NU author(s): Dr Kate Sumpter


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© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background & Aims: The Albumin-Bilirubin (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 subclassification by points (5–15) within the CP classification. Methods: We retrospectively analysed data from patients treated with sorafenib for HCC from 17 centres in United Kingdom and France. Overall survival (OS) was analysed using 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 1019 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.

Publication metadata

Author(s): Edeline J, Blanc J-F, Johnson P, Campillo-Gimenez B, Ross P, Ma YT, King J, Hubner RA, Sumpter K, Darby S, Evans J, Iwuji C, Swinson D, Collins P, Patel K, Muazzam I, Palmer DH, Meyer T

Publication type: Article

Publication status: Published

Journal: Liver International

Year: 2016

Volume: 36

Issue: 12

Pages: 1821-1828

Print publication date: 01/12/2016

Online publication date: 22/06/2016

Acceptance date: 18/05/2016

ISSN (print): 1478-3223

ISSN (electronic): 1478-3231

Publisher: Blackwell Publishing Ltd


DOI: 10.1111/liv.13170


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