Use of albumin and CRP related i̇mmuno-nutritional markers for prediction of locoregional response to treatment i̇n unresectable hepatocellular carcinoma

Abstract

Purpose: We examined the relationship between albumin and C reactive protein (CRP)-related inflammation markers such as Controlling nutritional status (Conut) score, lymphocyte-albumin factor (LA), albumin-bilirubin score (ALBI), highly sensitive modified Glasgow prognostic score (Hs-mGPS), Glasgow prognostic score (GPS) and locoregional treatment response in HCC. Materials and methods: One hundred and eighty HCC patients and 63 patients who underwent locoregional therapy were included in this study. Routine laboratory tests between the fourth and eighth week after treatment were recorded and albumin and CRP-related immuno-nutrition scores were calculated. Cut-off values from the literature were used. The predictive and prognostic value of these markers for overall survival (OS) and disease-free survival (DFS) after treatment were analyzed. Results: The mean age was 63 years (min-max:26-87) and 59 (93.7%) of the patients were male. The mean follow-up period was 25 months and 53 patients were deceased (84.1%). Median overall survival (mOS):18.56 months (min-max:13.13-23.99); median disease-free survival (mDFS):7 months (min-max:3.63-10.37) after locoregional treatment. Age (p=0.019), Conut (p=0.001), GPS (p=0.028), Hs-mGPS (p=0.012), LA (p=0.017) and ALBI (p=0.002) were significantly correlated with mOS. Conut (p=0.002), GPS (p<0.001), Hs-mGPS (p=0.002), LA (p=0.002) and ALBI (p=0.001) were significantly correlated with mDFS. Multivariate analysis revealed that those aged ≥65 years (HR:2.10; 95% CI:1.02-4.30; p=0.042) and those who received no systemic therapy (HR:4.11; 95% CI:1.35-12.56; p=0.013) had an increased risk of death (p<0.001). Another significant result was that a GPS of '2' (HR:6.62; 95% CI:1.13-38.62; p=0.036) predicted a higher risk of progression (p<0.001). Conclusion: In this study, we found that age, Conut score, GPS, HsmGPS, LA and ALBI score significantly predicted mOS and mDFS in locoregionally treated HCC patients. All these results suggest that our prognostic modelling may be useful in clinical practice. © 2025, Pamukkale University. All rights reserved.