Prognostic value of albi score and lymphocyte-associated inflammation markers in advanced hepatocellular carcinoma: a single centre retrospective cross-sectional study

Abstract

Aim According to the information obtained from the World Health Organization database, the incidence of hepatocellular carcinoma (HCC) in Turkey increased by 17.78% between the years of 2018 and 2020. In this study, we investigated the prognostic value of albumin-bilirubin (ALBI) score and lymphocyte-associated inflammation markers on overall survival (OS) and progression-free survival (PFS) in advanced hepatocellular carcinoma. Materials and Methods Data of 141 patients with advanced HCC were included in this study. ALBI score and lymphocyte-associated inflammatory marker were calculated. As a result, the prognostic significance of these tests for survival were evaluated. Results The median age was 65 years (min: 26-max: 88). There were 58 (41.1%) hepatitis B virus (HBV) positive, 20 (14.2%) hepatitis C (HCV) positive and 63 (44.7%) patients with no history of hepatitis. Cut-off values of ALBI score and lymphocyte-associated inflammation markers were found by receiver operating characteristic analysis. ALBI (p<0.001), aspartate aminotransferase-to-lymphocyte ratio (ALRI) (p<0.001), prognostic nutritional index (PNI) (p=0.030), hemoglobin, albumin, lymphocyte, and platelet score (HALP) (p=0.003) scores were significantly associated with survival. In multivariate analysis, being >= 65 years old [hazard ratios (HR): 2.13; 95% confidence interval (CI): 1.44-3.17; p<0.001], ALRI >= 30.79 (HR: 2.14; 95% CI: 1.20-3.82; p=0.009) predicted an increased risk of death and ALBI >=-2.54 (HR: 0.44, 95% CI: 0.29-0.69; p<0.001) predicted a decreased risk of death. Being >= 65 years old (HR: 174, 95% CI: 1.18-2.56; p=0.005) increased the risk of progression. Conclusion This study supports the statistically significant association of ALBI score and lymphocyte-associated inflammation markers (ALRI, PNI, HALP) with OS and PFS in advanced HCC patients. It is thought that this study will contribute to the literature and clinical practice.