• Ryan Hickey, Samdeep Mouli, Laura Kulik, Kush Desai, Bartley Thornburg, Daniel Ganger, Talia Baker, Michael Abecassis, Joseph Ralph Kallini, Ahmed Gabr, Vanessa L Gates, Al B Benson Iii, Robert J Lewandowski, and Riad Salem.
• Section of Interventional Radiology, Comprehensive Transplant Center, Department of Surgery, Northwestern University, 676 North St. Clair, Suite 800, Chicago, IL 60611.
• J Vasc Interv Radiol. 2016 Jun 1; 27 (6): 795-802.

PurposeTo assess validity of albumin-bilirubin (ALBI) grade as a predictor of survival in patients undergoing transarterial embolization for hepatocellular carcinoma.Materials And MethodsBaseline albumin and bilirubin values of 765 consecutive patients treated with conventional transarterial chemoembolization or yttrium-90 ((90)Y) radioembolization at a single institution were used to determine liver function according to ALBI grade. Survival outcomes were stratified by ALBI grade using Kaplan-Meier and stratified by Child-Pugh (C-P) class and Barcelona Clinic Liver Cancer (BCLC) stage. Discriminatory ability was assessed by C-index.ResultsFor 428 patients receiving (90)Y radioembolization, ALBI grade yielded distinct survival curves (P < .001). When stratified by C-P class and BCLC stage, ALBI grade revealed different survival outcomes for C-P B (P = .001), BCLC A (P < .001), BCLC B (P = .001), and BCLC C (P < .001). When substratified by BCLC stage, ALBI grade was a better discriminator of survival than C-P class (C-index 0.792, 0.763, respectively). For 337 patients receiving transarterial chemoembolization, ALBI grade yielded distinct survival curves (P < .001). When stratified by C-P class and BCLC stage, ALBI grade provided distinct survival curves for C-P B (P = .02), BCLC B (P = .001), and BCLC C (P = .02). When substratified by BCLC stage, ALBI grade was a better discriminator of survival than C-P class (C-index 0.739, 0.735, respectively).ConclusionsALBI grade outperforms C-P class at discriminating survival in patients receiving transarterial chemoembolization or (90)Y radioembolization. ALBI grade is also valuable in patients with moderate liver dysfunction and BCLC B disease.Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

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