Prognostic role of the Child-Turcotte-Pugh classification and ALBI grade in patients without cirrhosis and hepatocellular carcinoma.
Across two observational HCC cohorts, CTP classification and ALBI grade were associated with overall survival in patients without cirrhosis, with prognostic performance comparable to that observed in patients with cirrhosis.
Open original publication →What the AI sees
Across two observational HCC cohorts, CTP classification and ALBI grade were associated with overall survival in patients without cirrhosis, with prognostic performance comparable to that observed in patients with cirrhosis.
Research significance
Evidence: CTP and ALBI measures independently stratified overall-survival prognosis in non-cirrhotic, unresectable HCC. Inference: these readily available measures might improve risk stratification or treatment-selection frameworks, but the record does not show that their use changes therapy, reduces toxicity, or improves outcomes, and it provides no pediatric-specific evidence.
Source abstract
BACKGROUND & AIMS: While the Child-Turcotte-Pugh (CTP) classification as well as the albumin-bilirubin (ALBI) grade represent important clinical tools for risk stratification in patients with cirrhosis and hepatocellular carcinoma (HCC), there is no data on the prognostic ability in patients without cirrhosis and HCC. METHODS: Cohort 1 included unresectable patients with HCC and BCLC stage A-C from the Medical University of Vienna and the Sorbonne University, Paris. Cohort 2 included patients with unresectable HCC treated with atezolizumab/bevacizumab or durvalumab/tremelimumab from two large international databases (AB-Real and DT-Real studies). We evaluated the prognostic value of the CTP classification/ALBI grade for overall survival (OS) by calculating Cox regression analyses as well as time-dependent AUROCs. RESULTS: Cohort 1 included 184 patients without cirrhosis (CTP-B: n=22/12.0%) and 1173 patients with cirrhosis (CTP-B: n=414/35.3%), and cohort 2 comprised 259 patients without cirrhosis (CTP B: n=19/7.3%) and 841 patients with cirrhosis (CTP-B: n=187/23.3%). CTP classification was independently associated with OS in cohorts 1 (aHR: 3.04 [95%CI: 1.70-5.45], p<0.001) and 2 (aHR: 3.24 [95%CI: 1.73-6.08], p<0.001), independent of BCLC stage and other relevant prognostic factors. Time-dependent AUROCs of CTP score were comparable at the analysed timepoints. Similar results were observed for ALBI grade. CONCLUSION: CTP classification and ALBI grade are associated with prognosis in patients without cirrhosis and HCC, and their prognostic power is comparable to that in patients with cirrhosis and HCC.