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Appraisal of a newly developed ALBI-sarcopenia score as a prognostic marker in patients with hepatocellular carcinoma

2024; Lippincott Williams & Wilkins; Volume: 36; Issue: 7 Linguagem: Inglês

10.1097/meg.0000000000002776

1473-5687

Maha Elsabaawy, Hanaa Badran, Amr Ragab, Rasha Abdelwahab, Eman Sayed, Sameh Afify, Warda Othman,

Liver Disease and Transplantation

Objective This study aimed to evaluate the impact of the combined Albumin–bilirubin (ALBI)/sarcopenia score as a newly developed prognostic model for hepatocellular carcinoma (HCC), with a focus on its utility in predicting mortality. Methods This prospective study was conducted on HCC patients who were followed for 1 year or until death. Sarcopenia was assessed radiologically by computed tomography at the level of L3. The study consisted of two sets: a development set in which the new ALBI-sarcopenia score was created, comprising 262 HCC patients, followed by an internal validation set with 100 patients. Results The development cohort primarily included males (69.5%), aged 59.6 ± 8.09 years. In patients with sarcopenia, the ALBI score was −2.03 ± 0.42 ( P < 0.006), the model for end-stage liver disease (MELD) score was 11.29 ± 2.43 ( P < 0.001*), and the MELD-sarcopenia score was 21.29 ± 2.43 ( P < 0.001*). The distribution of barcelona clinic liver cancer (BCLC) staging was as follows: BCLC A 18 (15.9%), BCLC B 63 (55.8%) and BCLC C 32 (28.3%) ( P < 0.001*), with a notable association with higher mortality ( P < 0.001). Multivariate analysis identified sarcopenia and ALBI scores as independent predictors of mortality in HCC ( P < 0.001*). In the development set, the ALBI-sarcopenia score successfully predicted mortality at a cutoff >−11 with an area under a curve of 0.837 (95% CI, 0.784–0.889), while in the validation set, it predicted mortality at a cutoff >−11.55 with an area under a curve of 0.842 (95% CI, 0.753–0.930). Conclusion The newly introduced ALBI-sarcopenia score has demonstrated superior effectiveness in comparison to MELD-sarcopenia score, overcoming the shortcomings associated MELD score in forecasting outcomes for patients with HCC.