Albumin-bilirubin grade as a prognostic indicator for patients with non-hepatocellular primary and metastatic liver malignancy undergoing Yttrium-90 radioembolization using resin microspheres

Antoine Azar, Zlatko Devcic, Ricardo Paz-Fumagalli, Lucas Lauar Cortizo Vidal, J. Mark McKinney, Gregory Frey, Andrew R. Lewis, Charles Ritchie, Jason S. Starr, Kabir Mody, Beau Toskich

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Studies have shown that the albumin-bilirubin (ALBI) grade can be a superior prognosticator for patients undergoing Yttrium-90 (Y90) glass microsphere radioembolization for hepatocellular carcinoma (HCC) compared to the Child-Pugh (CP) scoring system. Less is known about the applicability of this score in non-hepatocellular malignancies using Y90 resin microspheres. This study evaluates the ALBI grade's ability to predict overall survival and biochemical toxicity in patients undergoing resin Y90 radioembolization and body surface area dosimetry (BSA) for non-hepatocellular primary and metastatic liver malignancies compared to the CP class and Model for End-Stage Liver Disease (MELD) score. Methods: A retrospective review of patients with intrahepatic metastatic colorectal and neuroendocrine cancers and cholangiocarcinoma undergoing resin radioembolization from 2006-2015 at a single tertiary medical center was performed. ALBI, MELD, and CP scores were compared and correlated with biochemical toxicity and overall survival. Results: There was a significant difference in overall survival between CP class A and class B liver function (P=0.04) for the entire patient cohort. ALBI grade (P=0.36) and MELD score (P=0.19) were not independently associated with survival. When stratified by CP class, the ALBI grade revealed a trend for survival difference in CP class B (P=0.05). Baseline ALBI grade was associated with post-procedural albumin reduction (P=0.01) and bilirubin elevation (P=0.007). Conclusions: ALBI grade predicted post-procedural biochemical toxicity, but did not predict survival after resin radioembolization of non-hepatocellular liver malignancies using BSA dosimetry. Given the heterogeneity of this study population, dedicated prospective analyses are required.

Original languageEnglish (US)
Pages (from-to)715-723
Number of pages9
JournalJournal of Gastrointestinal Oncology
Volume11
Issue number4
DOIs
StatePublished - Aug 1 2020

Keywords

  • Cholangiocarcinoma
  • Colorectal neoplasms
  • Liver neoplasms
  • Neuroendocrine carcinoma
  • Therapeutic embolization

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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