Incorporating ALBI Grade with Geriatric Nutritional Risk Index Enhances Hepatocellular Carcinoma Risk Stratification.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver Cancer Pub Date : 2024-10-05 eCollection Date: 2025-04-01 DOI:10.1159/000541647

Heechul Nam, Pil Soo Sung, Sung Won Lee, Do Seon Song, Jung Hyun Kwon, Jeong Won Jang, Chang Wook Kim, Si Hyun Bae

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引用次数: 0

Abstract

Introduction: Despite its prognostic impact, nutritional status has not yet been integrated into the assessment of hepatocellular carcinoma (HCC). This study investigated the association between geriatric nutritional risk index (GNRI) and overall survival (OS) in patients with HCC using a nationwide registry.

Methods: Data from the Korea Central Cancer Registry between 2008 and 2019 were analyzed. We explored the integration of the GNRI with the albumin-bilirubin (ALBI) grade for prognostic stratification. Restricted cubic spline regression was used to assess the association between GNRI and survival, stratified by ALBI grade.

Results: Among the 16,416 treatment-naïve HCC patients, the ALBI grades were distributed as follows: grade 1, 7,409; grade 2, 7,445; and grade 3, 1,562. Patients were categorized according to Barcelona Clinic Liver Cancer (BCLC) stages: 5,132 stage 0/A, 2,608 stage B, 5,289 stage C, and 968 stage D. The median OS for all patients was 3.1 years (95% CI: 3.0-3.2) and significantly differed with the inclusion of ALBI grade and GNRI (p < 0.001). The effect of combining ALBI grade and GNRI was further evaluated for each BCLC stage. This risk stratification showed a significant correlation with OS for each BCLC stage (all p < 0.001), except for stage D (p = 0.082). Multivariate analysis revealed that a combination of favorable ALBI grade and high GNRI score was independently associated with decreased mortality risk.

Conclusion: The GNRI was significantly correlated with OS across ALBI grades and BCLC stages. Integrating the GNRI into the ALBI grade may enhance risk stratification for patients with HCC.

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将ALBI分级与老年营养风险指数结合可增强肝细胞癌风险分层。

导言：尽管营养状况对预后有影响，但它尚未被纳入肝细胞癌（HCC）的评估。本研究通过全国登记调查了HCC患者的老年营养风险指数（GNRI）与总生存期（OS）之间的关系。方法：分析2008年至2019年韩国中央癌症登记处的数据。我们探索了GNRI与白蛋白-胆红素（ALBI）分级的整合，以进行预后分层。使用限制性三次样条回归来评估GNRI与生存之间的关系，并按ALBI等级分层。结果：在16416例treatment-naïve HCC患者中，ALBI分级分布如下：1 7409级；二级7,445人；三年级，1562人。根据巴塞罗那临床肝癌（BCLC）分期对患者进行分类：5132例0/A期，2608例B期，5289例C期和968例d期。所有患者的中位OS为3.1年（95% CI: 3.0-3.2），与纳入ALBI分级和GNRI有显著差异（p < 0.001）。在BCLC的各个阶段进一步评价ALBI分级与GNRI结合的效果。除D期（p = 0.082）外，该风险分层显示每个BCLC分期与OS有显著相关性（均p < 0.001）。多变量分析显示，良好的ALBI分级和高GNRI评分与降低死亡风险独立相关。结论：在ALBI分级和BCLC分期中，GNRI与OS有显著相关。将GNRI纳入ALBI分级可能会加强HCC患者的风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver Cancer Medicine-Oncology

CiteScore

20.80

自引率

7.20%

发文量

审稿时长

16 weeks

期刊介绍： Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.