Meta-analysis of the value of albumin-bilirubin grading on changes in liver function and its prognostic assessment in patients with hepatocellular carcinoma treated with transhepatic arterial chemoembolization

Résumé fourni par la source

OBJECTIVE: To analyze the application effect of albumin-bilirubin (ALBI) classification in assessing the changes in liver function and prognosis of hepatocellular carcinoma (HCC) patients after transhepatic arterial chemoembolization (TACE). METHODS: Databases (such as Cochrane Library, PubMed, Embase, OVID, Web of Science) were used to collect and obtain all relevant studies on the changes in liver function and prognosis of HCC patients treated with TACE by ALBI classification. The literature was retrieved from the beginning of the database to September 2023. All analysis was performed by RevMan 5.4 software. RESULTS: 20 papers with 10,223 patients were included. Meta-analysis showed that the overall survival (OS) after TACE was shorter in HCC patients with higher ALBI grades than in those with lower ALBI grades (2nd vs. 1st : OR = 1.52, 95% CI: 1.42-1.64, P < 0.00001; 3rd vs. 1st : OR = 2.67, 95% CI: 1.87-3.80, P < 0.00001; 3rd vs. 2nd : OR = 1.94, 95% CI: 1.67-2.26, P < 0.00001). ALBI worsened more with 2 TACE accumulations than with 1 TACE (OR = 1.78, 95% CI: 1.11-2.85, P = 0.02), more with 3 TACE accumulations than with 1 TACE (OR = 3.22, 95% CI: 1.96-5.29, P < 0.00001), and more with 3 TACE accumulations than with 2 TACE (OR = 1.70, 95% CI: 1.07-2.71, P = 0.03). In addition, ALBI predicted the occurrence of ACLF (OR = 4.57, 95% CI: 2.76-7.57, P < 0.00001). CONCLUSION: ALBI classification is clinically important in assessing the prognosis of TACE and predicting the risk of ACLF, and repeated TACE treatment may lead to increased liver function impairment.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.