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Expert Review of Gastroenterology & Hepatology Volume 16, 2022 - Issue 9
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Original Research

Tumor burden score as a new prognostic surrogate in patients with hepatocellular carcinoma undergoing radiofrequency ablation: role of albumin-bilirubin (ALBI) grade vs easy ALBI grade

Shu-Yein Hoa Division of Gastroenterology and Hepatology, Min-Sheng General Hospital, Taoyuan, Taiwan;b Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan;c School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanView further author information
,
Po-Hong Liuc School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;d Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USAView further author information
,
Chia-Yang Hsuc School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;e VA Sierra Nevada Health Care System, Reno, Nevada, USAView further author information
,
Yi-Hsiang Huangc School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;f Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;g Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanView further author information
,
Jia-I Liaoc School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;f Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanView further author information
,
Chien-Wei Suc School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;f Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanView further author information
,
Ming-Chih Houc School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;f Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanView further author information
&
Teh-Ia Huob Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan;c School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;h Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, TaiwanCorrespondence[email protected]
View further author information
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Pages 903-911 | Received 24 May 2022, Accepted 22 Aug 2022, Published online: 01 Sep 2022
 
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ABSTRACT

Introduction

Tumor burden score (TBS) was proposed to represent tumor burden in solid tumors, including hepatocellular carcinoma (HCC). The prognostic role of TBS in HCC patients in relation to recently introduced liver reserve markers, albumin-bilirubin (ALBI) grade, and easy (EZ)-ALBI grade, is unclear. We aimed to investigate the feasibility of TBS in HCC patients undergoing radiofrequency ablation (RFA).

Research design and methods

A total of 576 treatment-naïve patients with HCC undergoing RFA were analyzed. The multivariate Cox analysis was used to identify independent predictors associated with tumor recurrence and long-term survival.

Results

Patients with high TBS had increased risk of tumor recurrence and mortality compared with those with low TBS. The Cox analysis showed that serum ɑ-fetoprotein (AFP) level >20 ng/mL, medium and high TBS, ALBI grade 2 and grade 3, EZ-ALBI grade 2 and grade 3 were associated with tumor recurrence and decreased patient survival (all p <0.05). In addition, TBS can reliably stratify tumor recurrence and overall survival in different ALBI and EZ-ALBI grade groups.  

Conclusions

TBS is a simple and feasible prognostic surrogate to predict tumor recurrence and survival in HCC patients undergoing RFA. Its prognostic ability remains stable in patients with variable liver functional reserve.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was funded by the grants from Taipei Veterans General Hospital (V111C-011, VN111-07), Taipei, Taiwan.

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