Universität zu Köln

Mueller, Lukas, Hahn, Felix, Maehringer-Kunz, Aline, Stoehr, Fabian, Gairing, Simon Johannes ORCID: 0000-0003-3240-5152, Foerster, Friedrich ORCID: 0000-0002-3234-8891, Weinmann, Arndt ORCID: 0000-0003-1198-1716, Galle, Peter Robert, Mittler, Jens ORCID: 0000-0002-2469-6036, dos Santos, Daniel Pinto, Pitton, Michael Bernhard, Dueber, Christoph and Kloeckner, Roman ORCID: 0000-0001-5492-4792 (2021). Refining Prognosis in Chemoembolization for Hepatocellular Carcinoma: Immunonutrition and Liver Function. Cancers, 13 (16). BASEL: MDPI. ISSN 2072-6694

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Abstract

Simple Summary The combination of the albumin-bilirubin (ALBI) grading and the Prognostic Nutritional Index (PNI) offers potential as a highly predictive tool for patients with hepatocellular carcinoma (HCC). The present study evaluated this combination firstly for patients undergoing transarterial chemoembolization (TACE). Both the ALBI grade and PNI were strong independent predictors of survival. However, the combination of the two scores allowed for even more precise predictions. In addition, this new ALBI-PNI outperformed several established scoring systems. Thus, the easy-to-calculate ALBI-PNI may be a promising stratification tool for patients with HCC undergoing TACE in daily clinical routine. A combination of albumin-bilirubin (ALBI) grading and the Prognostic Nutritional Index (PNI) was identified recently as a highly predictive tool for patients with hepatocellular carcinoma (HCC) undergoing tumor ablation. The present study evaluated this combination in patients undergoing transarterial chemoembolization (TACE). Between 2010 and 2020, 280 treatment-naive patients were retrospectively identified. The influence of ALBI grade, PNI and the novel ALBI-PNI on the median overall survival (OS) was assessed. In the next step, the prognostic ability of the combined approach was compared to established scoring systems. Both ALBI grade 2-3 and a low PNI were highly predictive for median OS (ALBI grade 1-3: 39.0 vs. 16.3 vs. 5.4 months, p < 0.001; high vs. low PNI: 21.4 vs. 7.5, p < 0.001). The combination of both resulted in a median OS of 39.0, 20.1, 10.3, and 5.4 months (p < 0.001). With a Concordance Index (C-Index) of 0.69, ALBI-PNI outperformed each individual score (ALBI 0.65, PNI 0.64) and was also better than BCLC, HAP, mHAP-II, and the Six-and-Twelve score (C-Indices 0.66, 0.60, 0.59, and 0.55). Thus, the easy-to-calculate ALBI-PNI may be a promising stratification tool for patients with HCC undergoing TACE, reflecting both immunonutritive status and liver function.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Maehringer-Kunz, Aline UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoehr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gairing, Simon Johannes UNSPECIFIED orcid.org/0000-0003-3240-5152 UNSPECIFIED Foerster, Friedrich UNSPECIFIED orcid.org/0000-0002-3234-8891 UNSPECIFIED Weinmann, Arndt UNSPECIFIED orcid.org/0000-0003-1198-1716 UNSPECIFIED Galle, Peter Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Mittler, Jens UNSPECIFIED orcid.org/0000-0002-2469-6036 UNSPECIFIED dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Pitton, Michael Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Dueber, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloeckner, Roman UNSPECIFIED orcid.org/0000-0001-5492-4792 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-574668
DOI:	10.3390/cancers13163961
Journal or Publication Title:	Cancers
Volume:	13
Number:	16
Date:	2021
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2072-6694
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ALBUMIN-BILIRUBIN GRADE; TRANSARTERIAL CHEMOEMBOLIZATION; NUTRITIONAL INDEX; PREDICTION; STAGE; SCORE; ART; SUBCLASSIFICATION; RETREATMENT; VALIDATION Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57466