Meta-analysis of the value of albumin-bilirubin grading on changes in liver function and its prognostic assessment in patients with hepatocellular carcinoma treated with transhepatic arterial chemoembolization
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View abstract on PubMed
Summary
This summary is machine-generated.The albumin-bilirubin (ALBI) classification effectively assesses liver function and prognosis in hepatocellular carcinoma (HCC) patients undergoing transhepatic arterial chemoembolization (TACE). Higher ALBI grades correlate with poorer overall survival and increased risk of acute-on-chronic liver failure (ACLF).
Area Of Science
- Hepatology
- Oncology
- Medical Diagnostics
Background
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Transhepatic arterial chemoembolization (TACE) is a standard treatment for HCC.
- Assessing liver function and prognosis in HCC patients undergoing TACE is crucial for treatment planning and patient outcomes.
Purpose Of The Study
- To evaluate the effectiveness of the albumin-bilirubin (ALBI) classification system.
- To analyze changes in liver function and patient prognosis after TACE in HCC.
- To determine the predictive value of ALBI for acute-on-chronic liver failure (ACLF) in this patient group.
Main Methods
- A comprehensive literature search was conducted across major databases (PubMed, Embase, Cochrane Library, OVID, Web of Science) up to September 2023.
- Included 20 studies comprising 10,223 patients with HCC treated with TACE.
- Meta-analysis was performed using RevMan 5.4 software to assess overall survival (OS) and ALBI grade changes.
Main Results
- Higher ALBI grades were significantly associated with shorter OS in HCC patients post-TACE (e.g., 3rd vs. 1st grade: OR=2.67, P<0.00001).
- Repeated TACE treatments led to a significant worsening of ALBI scores (e.g., 3 vs. 1 TACE: OR=3.22, P<0.00001).
- ALBI classification demonstrated a strong predictive capability for the occurrence of ACLF (OR=4.57, P<0.00001).
Conclusions
- The ALBI classification is a valuable tool for assessing prognosis in HCC patients undergoing TACE.
- ALBI effectively predicts the risk of developing ACLF.
- Repeated TACE interventions may result in significant liver function impairment, as indicated by worsening ALBI scores.
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