Is the Y90-Radioembolization treatment effective on the intermediate-advanced stage of Hepatocellular Carcinoma and What is the Albumin-Bilirubin score's prediction factor for survival?

Evirgen, Sami; Cavus, Bilger; Gokturk, Suut; Iliaz, Raim; Ozkan, Zeynep Gozde; Baran, Bulent; Ciftcibası Ormeci, Aslı; Mutluay Soyer, Ozlem; Karaca, Cetin; Demir, Kadir; Besisik, Selman Fatih; Poyanli, Arzu; Akyuz, Filiz; Kaymakoglu, Sabahattin

doi:10.14744/hf.2022.2022.0036

Sami Evirgen¹ ,

Bilger Cavus¹ ,

Suut Gokturk¹ ,

Raim Iliaz¹ ,

Zeynep Gozde Ozkan² ,

Bulent Baran¹ ,

Aslı Ciftcibası Ormeci¹ ,

Ozlem Mutluay Soyer¹ ,

Cetin Karaca¹ ,

Kadir Demir¹ ,

Selman Fatih Besisik¹ ,

Arzu Poyanli³ ,

Filiz Akyuz¹ ,

Sabahattin Kaymakoglu¹

¹Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye
²Department of Nuclear Medicine, Istanbul University School of Medicine, Istanbul, Turkiye
³Department of Radiology, Istanbul University School of Medicine, Istanbul, Turkiye Background and

Hepatology Forum 2023; 4(3): 103-107 DOI: 10.14744/hf.2022.2022.0036 PMCID: PMC10564249

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Abstract

Background and Aim: Radioembolization (RE) is a one of the palliative treatments that have been used to down stage and/or increase the survival time in intermediate-advanced stages of HCC. We aimed to evaluate the clinical impact of RE and the clinical use of the albumin-bilirubin (ALBI) score as a predictor for survival in HCC patients.
Material and Methods: Fifty-nine unresectable hepatocellular carcinoma (HCC) patients were enrolled. RE was performed in 28 of them (group 1) and 31 patients were followed up in the natural course (NC) (group 2). Patients were classified according to the Child-Pugh score (only cirrhotic patients), Barcelona clinic liver cancer (BCLC) staging, and ALBI scores were also calculated.
Results: All patients in Group 1 were cirrhotic and their BCLC stages were as follows: 60.7% stage B and 39.3% stage C. In Group 2, 83.9% of patients were cirrhotic and their BCLC stages were as follows: 9.7% stage B, 51.6% stage C, and 38.7% stage D. Mortality rates were 82% and 100% in Groups 1 and 2, respectively. The median overall survival (OS) was 13.5 months (95% CI: 10.4–16.6 months) and 4.5 months (95% CI: 3.5–5.5 months) in Groups 1 and 2, respectively (p=0.000). When RE was applied to patients with ALBI Grade 1 and 2, the median OS was statistically higher than in the NC group, respectively (p<0.001, p<0.001).
Conclusion: RE is an effective treatment method at the advanced stages of HCC. The ALBI score is a more useful and practical than the other prognostic tools.

Keywords: ALBI score; hepatocellular carcinoma; natural course; ra-dioembolization.