Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency
The severity of liver functional reserve is an important prognostic predictor in hepatocellular carcinoma (HCC). The albumin–bilirubin (ALBI), easy (EZ)-ALBI, platelet-albumin–bilirubin (PALBI), platelet–albumin (PAL) score, and MELD 3.0 score are used to evaluate the severity of liver dysfunction....
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| Format: | Article |
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MDPI AG
2023-11-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/23/16987 |
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| author | Shu-Yein Ho Po-Hong Liu Chia-Yang Hsu Hung-Ting Tseng Yi-Hsiang Huang Chien-Wei Su Ming-Chih Hou Teh-Ia Huo |
| author_facet | Shu-Yein Ho Po-Hong Liu Chia-Yang Hsu Hung-Ting Tseng Yi-Hsiang Huang Chien-Wei Su Ming-Chih Hou Teh-Ia Huo |
| author_sort | Shu-Yein Ho |
| collection | DOAJ |
| description | The severity of liver functional reserve is an important prognostic predictor in hepatocellular carcinoma (HCC). The albumin–bilirubin (ALBI), easy (EZ)-ALBI, platelet-albumin–bilirubin (PALBI), platelet–albumin (PAL) score, and MELD 3.0 score are used to evaluate the severity of liver dysfunction. However, their prognostic role in HCC patients, specifically with renal insufficiency (RI), is unclear. We aimed to investigate the predictive accuracy of the five models in these patients. A total of 1120 newly diagnosed HCC patients with RI were enrolled. A multivariate Cox proportional analysis was used to identify independent predictors associated with survival. In the Cox model, older age, an α-fetoprotein ≥20 ng/mL, vascular invasion, a medium and high tumor burden score, poor performance status, a higher ALBI grade, an EZ-ALBI grade, a PALBI grade, a PAL grade, and MELD 3.0 score were all independently associated with decreased overall survival (all <i>p</i> < 0.001). Among the five liver reserve models, the ALBI grade is the best surrogate marker to represent liver functional reserve in terms of outcome prediction. The albumin-based liver reserve models (ALBI, EZ-ALBI, PALBI, and PAL) and MELD 3.0 are all feasible prognostic markers to indicate liver injury, specifically in HCC patients with RI. Among them, the ALBI grade is the most robust tool for survival prediction in these patients. |
| first_indexed | 2024-03-09T01:48:35Z |
| format | Article |
| id | doaj.art-19766c2ee26648c2b6fec4b18d30ac4e |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T01:48:35Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-19766c2ee26648c2b6fec4b18d30ac4e2023-12-08T15:17:58ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-11-0124231698710.3390/ijms242316987Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal InsufficiencyShu-Yein Ho0Po-Hong Liu1Chia-Yang Hsu2Hung-Ting Tseng3Yi-Hsiang Huang4Chien-Wei Su5Ming-Chih Hou6Teh-Ia Huo7Division of Gastroenterology and Hepatology, Min-Sheng General Hospital, Taoyuan 33044, TaiwanDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USAVA Sierra Nevada Health Care System, Reno, NV 89502, USASchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanHealthcare & Services Center, Taipei Veterans General Hospital, Taipei 11217, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanDepartment of Medical Research, Taipei Veterans General Hospital, Taipei 11217, TaiwanThe severity of liver functional reserve is an important prognostic predictor in hepatocellular carcinoma (HCC). The albumin–bilirubin (ALBI), easy (EZ)-ALBI, platelet-albumin–bilirubin (PALBI), platelet–albumin (PAL) score, and MELD 3.0 score are used to evaluate the severity of liver dysfunction. However, their prognostic role in HCC patients, specifically with renal insufficiency (RI), is unclear. We aimed to investigate the predictive accuracy of the five models in these patients. A total of 1120 newly diagnosed HCC patients with RI were enrolled. A multivariate Cox proportional analysis was used to identify independent predictors associated with survival. In the Cox model, older age, an α-fetoprotein ≥20 ng/mL, vascular invasion, a medium and high tumor burden score, poor performance status, a higher ALBI grade, an EZ-ALBI grade, a PALBI grade, a PAL grade, and MELD 3.0 score were all independently associated with decreased overall survival (all <i>p</i> < 0.001). Among the five liver reserve models, the ALBI grade is the best surrogate marker to represent liver functional reserve in terms of outcome prediction. The albumin-based liver reserve models (ALBI, EZ-ALBI, PALBI, and PAL) and MELD 3.0 are all feasible prognostic markers to indicate liver injury, specifically in HCC patients with RI. Among them, the ALBI grade is the most robust tool for survival prediction in these patients.https://www.mdpi.com/1422-0067/24/23/16987hepatocellular carcinomaALBIPALBIEZ-ALBIPALMELD |
| spellingShingle | Shu-Yein Ho Po-Hong Liu Chia-Yang Hsu Hung-Ting Tseng Yi-Hsiang Huang Chien-Wei Su Ming-Chih Hou Teh-Ia Huo Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency International Journal of Molecular Sciences hepatocellular carcinoma ALBI PALBI EZ-ALBI PAL MELD |
| title | Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency |
| title_full | Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency |
| title_fullStr | Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency |
| title_full_unstemmed | Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency |
| title_short | Albumin-Based Liver Reserve Models vs. MELD 3.0 in Prognostic Prediction for Hepatocellular Carcinoma Patients with Renal Insufficiency |
| title_sort | albumin based liver reserve models vs meld 3 0 in prognostic prediction for hepatocellular carcinoma patients with renal insufficiency |
| topic | hepatocellular carcinoma ALBI PALBI EZ-ALBI PAL MELD |
| url | https://www.mdpi.com/1422-0067/24/23/16987 |
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