Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

Figures & data

Table 1. Baseline characteristics of the patients.

Characteristics	Number
Total	78
Age (years), Mean ± SD (range)	59.6 ± 10 (40–77)
<65	60 (76.9)
≥65	18 (23.1)
Gender
Male	57 (73.0)
Female	21 (27.0)
Etiology
HBV/HCV	16 (20.5)
No hepatitis	62 (79.5)
Comorbidities
Yes	35 (44.9)
No	43 (55.1)
Hepatic cirrhosis
Yes	24 (30.8)
No	54 (69.2)
Tumor size (cm), mean ± SD (range)	3.1 ± 0.7 (0.8–50)
<3	36 (46.2)
≥3	42 (53.8)
Tumor number, total (range)	106 (1–3)
Single	50 (64.1)
Multiple	28 (35.9)
Differentiation
Low	31 (39.7)
Moderate	47 (60.3)
CA-199 (U/ml)*	43.1 (9.8–236.9)
GGT (U/L)*	35.6 (11.3–452.6)
Albumin (g/L), mean ± SD (range)	39.6 ± 4.6 (31.3–48.1)
Bilirubin (g/L)*	20.2 (5.0–41.9)
Platelet count (10^9)*	212.3 (60–296)
INR, mean ± SD (range)	1.1 ± 0.2 (0.8–1.4)
Child–Pugh score
5	55 (70.5)
6	23 (29.5)
ALBI grade
1	39 (50.0)
2	39 (50.0)
Follow-up (months)*	22.7 (1–86.7)

Unless otherwise indicated data are number of patients, with percentage in parentheses.

* Data are medians, with interquartile range in parentheses.

SD: standard deviation; ALBI: albumin-bilirubin; HBV: hepatitis B virus; HCV: hepatitis C virus; cm: centimeter; GGT: γ-gammaglutamyl transpeptidase; INR: international normalized ratio.

Table 2. Characteristics of the patients stratified by ALBI grade.

Characteristics	ALBI grade 1 (n = 39)	ALBI grade 2 (n = 39)	p value
Age (years)*	60.4 ± 10.50	58.1 ± 11.34	.112
Etiology			.575
HBV/HCV	9 (23.0)	7 (17.9)
No hepatitis	30 (77.0)	32 (82.1)
Comorbidities			.495
Yes	19 (48.7)	16 (41.0)
No	20 (51.3)	23 (59.0)
Hepatic cirrhosis			.624
Yes	11 (28.2)	13 (33.3)
No	28 (71.8)	26 (66.7)
Tumor size (cm)			.173
<3	15 (38.5)	21 (53.8)
≥3	24 (61.5)	18 (46.2)
Tumor number			.059
Single	29 (74.4)	21 (53.8)
Multiple	10 (25.6)	18 (46.2)
CA-199 (U/ml)^†	42.2 (9.8–127.3)	44.8 (15.9–236.9)	.085
GGT (U/L)^†	34.1 (11.3–236.8)	36.3 (46.9–452.6)	.120
Platelet count (10^9/L)^†	134.0 (50.0–478.0)	147.0 (50.0–392.0)	.609
INR^†	1.03 (0.85–1.44)	1.09 (0.85–2.55)	.108

Unless otherwise indicated data are number of patients, with percentage in parentheses.

* Data are means ± standard deviation.

† Data are medians, with interquartile range in parentheses.

ALBI: albumin-bilirubin; HBV: hepatitis B virus; HCV: hepatitis C virus; cm: centimeter; GGT: γ-gammaglutamyl transpeptidase; INR: international normalized ratio.

Figure 1. Representative pictures of the patient with ICC after CT-PMWA. (a&b): Pre-PMWA MRI images (A: contrast-enhanced T1WI; B:T2WI); (c&d): Two images of plain CT scan during PMWA procedure show the well location of PMWA electrode probes; (e–g): Post-PMWA MRI images (contrast-enhanced TIWI) at 6-month(e), 1-year(f), and 3-year(g), respectively.

Table 3. Factors associating with the overall survival of patients.

Factor	Univariate analysis		Multiple analysis
	HR (95% CI)	p value	HR (95% CI)	p value
Age (years)	0.65（0.21–1.99）	.446
<65	60
≥65	18
Gender	1.48（0.52–4.21）	.467
Male	57
Female	21
Etiology	0.67（0.14–3.28）	.800
HBV/HCV	16
No hepatitis	62
Comorbidities	0.56（0.21–1.49）	.249
Yes	35
No	43
Hepatic cirrhosis	1.23（0.43–3.49）	.704
Yes	24
No	54
Tumor size（cm）	3.29（1.07–10.1）	.038	9.03（1.01–80.52）	.049
<3	36
≥3	42
Tumor number	3.60（1.34–9.65）	.011	4.73（0.88–25.32）	.070
Single	50
Multiple	28
Differentiation	1.09（0.78–1.65）	.817
Low	31
Moderate	47
CA-199 (U/ml)	1.42（1.11–1.98）	.414
≤37	37
>37	41
GGT (U/L)	2.03（0.77–5.36）	.155
≤50	29
>50	49
Child–Pugh score	0.38（0.08–1.65）	.575
5	55
6	23
ALBI grade	3.92（1.37–11.23）	.011	9.56（1.58–58.00）	.014
1	39
2	39

ALBI: albumin-bilirubin; HBV: hepatitis B virus; HCV: hepatitis C virus; cm: centimeter; GGT: γ-gammaglutamyl transpeptidase; HR: hazard ratio; CI: confidence interval.

Table 4. Factors associating with the recurrence-free survival of patients.

	Univariate analysis		Multiple analysis
	HR (95% CI)	p value	HR (95% CI)	p value
Age (years)	0.81（0.29–2.29）	.696
<65	60
≥65	18
Gender	0.30（0.07–1.29）	.105
Male	57
Female	21
Etiology	2.92（0.38–22.28）	.197
HBV/HCV	16
No hepatitis	62
Comorbidities	0.75（0.29–1.90）	.541
Yes	35
No	43
Hepatic cirrhosis	1.98（0.21–3.09）	.871
Yes	24
No	54
Tumor size(cm)	1.73（0.65–4.63）	.012	2.30（0.69–8.04）	.049
<3	36
≥3	42
Tumor number	3.60（1.34–9.65）	.011	1.96（0.49–7.82）	.341
Single	50
Multiple	28
Differentiation	1.09（0.78–1.65）	.817
Low	31
Moderate	47
CA-199 (U/ml)	1.42（1.11–1.98）	.214
≤37	37
>37	41
GGT (U/L)	0.60（0.20–1.83）	.369
≤50	29
>50	49
Child–Pugh score	0.91（0.30–2.75）	.863
5	55
6	23
ALBI grade	1.01（0.40–2.57）	.003	1.38（0.38–5.06）	.624
1	39
2	39

ALBI: albumin-bilirubin; HBV: hepatitis B virus; HCV: hepatitis C virus; cm: centimeter; GGT: γ-gammaglutamyl transpeptidase; HR: hazard ratio; CI: confidence interval.

Figure 2. (A): Graph shows the cumulative 1-, 3- and 5-year overall survival rates of patients with ICCs after CT-guided PMWA treatment based on the Child score. (B): Graph shows the cumulative 1-, 3- and 5-year overall survival rates of patients with ICCs after CT-guided PMWA treatment based on the ALBI grade.

Figure 3. (A): Graph shows the cumulative 1-, 3- and 5-year overall survival rates of patients with a hepatic function of child score 5 after CT-guided PMWA treatment based on the ALBI grade. (B): Graph shows the cumulative 1-, 3- and 5-year overall survival rates of patients with a hepatic function of child score 6 after CT-guided PMWA treatment based on the ALBI grade.

Figure 4. (A): Graph shows the cumulative 1-, 3- and 5-year recurrence-free survival rates of patients with ICCs after CT-guided PMWA treatment based on the child score. (B): Graph shows cumulative 1-, 3- and 5-year recurrence-free survival rates of patients with ICCs after CT-guided PMWA treatment based on the ALBI grade.