Indexed on: 16 Mar '17Published on: 16 Mar '17Published in: Journal of Gastroenterology and Hepatology
The Albumin-Bilirubin (ALBI) grade is a new index to assess objectively liver function and prognosis in patients with hepatocellular carcinoma (HCC). This study aimed to elucidate the application of ALBI grade in baseline and sorafenib-end in advanced HCC patients received sorafenib.A total of 415 consecutive advanced HCC patients in Child-Pugh A received sorafenib in our hospital. Sorafenib was terminated when radiologic tumor progression, or clinical liver function deterioration (LD) occurred in the reassessment bi-monthly. Patients failed with sorafenib monotherapy were retrospectively analyzed.A total of 260 (62.6%) patients were enrolled, including 98 (37.7%) ALBI grade I and 162 (62.3%) grade II in baseline. More patients in ALBI grade II stopped sorafenib due to LD than grade I (33.3% vs 14.3%, p < 0.001). Those who in baseline ALBI grade I had a superior overall survival than grade II (8.5 months vs 4.4 months, p = 0.003). Cox regression analysis confirmed that baseline ALBI grade II (p < 0.001 ) and ALBI grade increase during treatment (p < 0.001) strongly contributed to the mortality of HCC patients received sorafenib. After sorafenib failure, those who with post-sorafenib treatment had a better post-sorafenib survivial than those without (9.3 months vs 1.6 months, p < 0.001). Logistic regression analysis indicated that sorafenib-end ALBI grade and LD occurrence were the only two predictors of post-sorafenib treatment after sorafenib failure.In clinical practice, we firstly demonstrated that not only ALBI grade in baseline but ALBI grade change during treatment could predict the prognosis of advanced HCC patients received sorafenib.