Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis
(1) Introduction: Liver resection (LR) for hepatocellular carcinoma (HCC) is often burdened by life-threatening complications, such as post-hepatectomy liver failure (PHLF). The albumin-bilirubin (ALBI) score can accurately evaluate liver function and the long-term prognosis of HCC patients, includi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/9/2011 |
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| author | Giovanni Marasco Luigina Vanessa Alemanni Antonio Colecchia Davide Festi Franco Bazzoli Giuseppe Mazzella Marco Montagnani Francesco Azzaroli |
| author_facet | Giovanni Marasco Luigina Vanessa Alemanni Antonio Colecchia Davide Festi Franco Bazzoli Giuseppe Mazzella Marco Montagnani Francesco Azzaroli |
| author_sort | Giovanni Marasco |
| collection | DOAJ |
| description | (1) Introduction: Liver resection (LR) for hepatocellular carcinoma (HCC) is often burdened by life-threatening complications, such as post-hepatectomy liver failure (PHLF). The albumin-bilirubin (ALBI) score can accurately evaluate liver function and the long-term prognosis of HCC patients, including PHLF. We aimed to evaluate the diagnostic value of the ALBI grade in predicting PHLF in HCC patients undergoing LR. (2) Methods: MEDLINE, Embase, and Scopus were searched through January 17th, 2021. Studies reporting the ALBI grade and PHLF occurrence in HCC patients undergoing LR were included. The Odds Ratio (OR) prevalence with 95% confidence intervals (CI) was pooled, and the heterogeneity was expressed as I<sup>2</sup>. The quality of the studies was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). (3) Results: Seven studies met the inclusion criteria and were included in the analysis. A total of 5377 patients who underwent LR for HCC were considered, of whom 718 (13.4%) developed PHLF. Patients with ALBI grades 2 and 3 before LR showed increased rates of PHLF compared to ALBI grade 1 patients. The pooled OR was 2.572 (95% CI, 1.825 to 3.626, <i>p</i> < 0.001), with substantial heterogeneity between the studies (I<sup>2</sup> = 69.6%) and no publication bias (Begg’s <i>p</i> = 0.764 and Egger’s <i>p</i> = 0.851 tests). All studies were at a ‘low risk’ or ‘unclear risk’ of bias. Univariate meta-regression analysis showed that heterogeneity was not dependent on the country of study, the age and sex of the participants, the definition of PHLF used, the rate of patients in Child–Pugh class A or undergoing major hepatectomy. (4) Conclusions: In this meta-analysis of published studies, individuals with ALBI grades of 2 and 3 showed increased rates of PHLF compared to ALBI grade 1 patients. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T11:37:17Z |
| publishDate | 2021-05-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-26a0f3843092487dba3c307e5252cfa12023-11-21T18:45:41ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-01109201110.3390/jcm10092011Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-AnalysisGiovanni Marasco0Luigina Vanessa Alemanni1Antonio Colecchia2Davide Festi3Franco Bazzoli4Giuseppe Mazzella5Marco Montagnani6Francesco Azzaroli7IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyIRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyGastroenterology Unit, University Hospital Borgo Trento, 37100 Verona, ItalyDepartment of Medical and Surgical Science, University of Bologna, 40126 Bologna, ItalyIRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Science, University of Bologna, 40126 Bologna, ItalyIRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyIRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy(1) Introduction: Liver resection (LR) for hepatocellular carcinoma (HCC) is often burdened by life-threatening complications, such as post-hepatectomy liver failure (PHLF). The albumin-bilirubin (ALBI) score can accurately evaluate liver function and the long-term prognosis of HCC patients, including PHLF. We aimed to evaluate the diagnostic value of the ALBI grade in predicting PHLF in HCC patients undergoing LR. (2) Methods: MEDLINE, Embase, and Scopus were searched through January 17th, 2021. Studies reporting the ALBI grade and PHLF occurrence in HCC patients undergoing LR were included. The Odds Ratio (OR) prevalence with 95% confidence intervals (CI) was pooled, and the heterogeneity was expressed as I<sup>2</sup>. The quality of the studies was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). (3) Results: Seven studies met the inclusion criteria and were included in the analysis. A total of 5377 patients who underwent LR for HCC were considered, of whom 718 (13.4%) developed PHLF. Patients with ALBI grades 2 and 3 before LR showed increased rates of PHLF compared to ALBI grade 1 patients. The pooled OR was 2.572 (95% CI, 1.825 to 3.626, <i>p</i> < 0.001), with substantial heterogeneity between the studies (I<sup>2</sup> = 69.6%) and no publication bias (Begg’s <i>p</i> = 0.764 and Egger’s <i>p</i> = 0.851 tests). All studies were at a ‘low risk’ or ‘unclear risk’ of bias. Univariate meta-regression analysis showed that heterogeneity was not dependent on the country of study, the age and sex of the participants, the definition of PHLF used, the rate of patients in Child–Pugh class A or undergoing major hepatectomy. (4) Conclusions: In this meta-analysis of published studies, individuals with ALBI grades of 2 and 3 showed increased rates of PHLF compared to ALBI grade 1 patients.https://www.mdpi.com/2077-0383/10/9/2011hepatocellular carcinomaliver surgeryhepatectomyliver failurealbumin-bilirubinALBI |
| spellingShingle | Giovanni Marasco Luigina Vanessa Alemanni Antonio Colecchia Davide Festi Franco Bazzoli Giuseppe Mazzella Marco Montagnani Francesco Azzaroli Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis Journal of Clinical Medicine hepatocellular carcinoma liver surgery hepatectomy liver failure albumin-bilirubin ALBI |
| title | Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis |
| title_full | Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis |
| title_fullStr | Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis |
| title_short | Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis |
| title_sort | prognostic value of the albumin bilirubin grade for the prediction of post hepatectomy liver failure a systematic review and meta analysis |
| topic | hepatocellular carcinoma liver surgery hepatectomy liver failure albumin-bilirubin ALBI |
| url | https://www.mdpi.com/2077-0383/10/9/2011 |
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