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

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

doi:10.1097/MEG.0000000000002776

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

Eur J Gastroenterol Hepatol. 2024 Apr 17. doi: 10.1097/MEG.0000000000002776. Online ahead of print.

Authors

Maha Elsabaawy¹, Hanaa Badran¹, Amr Ragab¹, Rasha Abdelwahab², Eman Sayed³, Sameh Afify¹, Warda Othman¹

Affiliations

¹ Hepatology and Gastroenterology Department.
² Radiology Department.
³ Anasethia and Intensive Care Department, National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt.

PMID: 38625821
DOI: 10.1097/MEG.0000000000002776

Abstract

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.