studies

456A AASLD ABSTRACTS HEPATOLOGY, October, 2015
Evidence-Based Approach-The ALBI Grade. J Clin Oncol. 2015
Feb 20;33(6):550-8
Disclosures:
The following authors have nothing to disclose: Simona Onali, Aileen Marshall,
Dinesh Sharma, Pam O’Donoghue, Emily Dannhorn, Phillip Johnson, James
O’Beirne
490
Albi score predicts survival independently of hepatic
venous pressure gradient (HVPG) and indocyanine
green (ICG) clearance in HCC patients undergoing resection
Aileen Marshall 1 , Simona Onali 1 , Dinesh Sharma 1 , Pam O’Donoghue
1 , Emily Dannhorn 1 , Phillip Johnson 2 , James O’Beirne 1 ;
1 Sheila Sherlock Liver Centre, Royal Free Hospital, London, United
Kingdom; 2 Department of Molecular and Clinical Cancer Medicine,
University of Liverpool, Liverpool, United Kingdom
Introduction: A new evidence based model, the Albumin-Bilirubin
(ALBI) grade † , has been recently proposed for assessing
liver function in patients with hepatocellular carcinoma
(HCC). We aimed to evaluate the impact of ALBI in predicting
decompensation and survival after liver resection (LR) for
HCC. Method: Consecutive patients undergoing resection for
HCC between 2011-2014 at the Royal Free Hospital were
evaluated. Demographic, clinical data and histopathological
features of resected tumour were collected. Patients underwent
HVPG and ICG clearance measurement to evaluate potential
resectability. ALBI score was calculated pre and post-operatively.
Patients were divided into 3 categories (ALBI 1,2,3)
according to published ALBI score cut-offs. Cox regression was
used to identify predictors of decompensation and survival post
LR. Results: 48 patients were included with a median post LR
follow up 17 months (1-54): male 42(87.5%), mean age 63
years (28-83). Median HVPG 6 mmHg(2-15), median ICG PDR
18.2 (6.1-29.4), median ICG R15 6.5 (1.2-19.2). All patients
had a Child Pugh score A5. 46 (96%) had a pre-LR ALBI grade
1 and 2 (4%) had an ALBI grade 2. Clinically significant portal
hypertension (HVPG ≥10mmHg) was found in 11 (23%)
patients. Eight (19%) patients had an ICG PDR 15. Thirty (62,5%) patients underwent
an anatomical resection, while 18 (37,5%) had a wedge
resection. Post-LR decompensation was observed in 5(10%)
patients: ascites n=4, encephalopathy n=1 at a median of 10
days post-LR. 12(25%) patients had HCC recurrence after a
mean time of 11 months (5-28). 7 (15%) died after a mean
follow up of 15 months (1-40), 3 of them due to tumour recurrence.
Patients with 1 HCC