Abstract 1004P
Background
Prognostic assessment system of hepatocellular carcinoma (HCC) should be based on liver function and tumor classification. Indeed, the use of an appropriate prognostic score became mandatory given the improvement of diagnostic methods and therapeutic strategies of HCC.The aim of our study was to assess the prognostic performance of ALBI score (albumin-bilirubin score), ALBI-T (albumin-bilirubin-TNM score), mALBI-T (modified albumin-bilirubin-TNM score) and PALBI (platelet-albumin-bilirubin score) in Tunisian patients with HCC.
Methods
We conducted a retrospective study including cirrhotic patients with HCC over a period of 9 years (2010-2018). ALBI and PALBI scores and grades were determined for each patient. ALBI-T score was obtained by adding the TNM stage to the ALBI grade and subtracting 2 points. The mALBI-T score was calculated by introducing new cut-off (–2.27) in grade 2 of ALBI to have a total of 4 grades (modified ALBI) and introducing this modification to ALBI-T score. The performance of the different scores were assessed with the area under the ROC curve (AUC).
Results
Overall, 120 patients were included with a sex ratio M/F = 1.85. The mean age was 61 ± 11.8 years. The most common etiology of the liver disease was viral. The HCC was inaugural in 38.4% of cases. Elsewhere, the most frequent discovery circumstances were: systematic screening (35.5%), abdominal pain (22.3%), decompensation (14%). HCC was classified BCLC A in 29.8%, BCLC B in 21.5%, BCLC C in 20.7% and BCLC D in 28%. Curative treatment was indicated in 22.3% of cases and palliative in 43.2% of cases. Symptomatic management was decided in 33.9% of patients. Survival at 1 and 3 years was 43.9 % and 15% respectively. By analyzing ROC curves, prognostic performances of the different scores concerning the mortality at 3 years were for ALBI score: AUC = 0.588, p= 0.518; for PALBI: AUC = 0.717, p=0.045; for ALBI-T: AUC = 0.743, p= 0.024 and for mALBI-T AUC = 0.755, p=0.022.
Conclusions
According to our study, ALBI score was not significantly correlated with survival. However, mALBI-T showed a better prognostic performance comparing to PALBI and ALBI-T, thus allowing better stratification of patients with HCC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.