Chan et al modified the Barcelona Clinic Liver Cancer (BCLC) system for hepatocellular carcinoma by the inclusion of the Albumin-Bilirubin (ALBI) score. The authors are from Prince of Wales Hospital (Hong Kong), The Chinese University of Hong Kong, Ogaki Municipal Hospital and the University of Liverpool.
Patient selection: hepatocellular carcinoma
Outcome: overall survival
Parameters:
(1) ECOG performance status (from 0 to 4)
(2) tumor stage
(3) Child-Pugh grade (A, B or C)
(4) albumin-bilirubin (ALBI) grade (1, 2, 3)
albumin-bilirubin (ALBI) score =
= (0.66 * LOG10(serum total bilirubin in µmol/L)) - (0.085 * (serum albumin in g/L))
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ALBI
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Grade
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<= - 2.60
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1
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-2.59 to -1.39
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2
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> -1.39
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3
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Modified BCLC Stage 1 - all of the following:
(1) ECOG 0
(2) single tumor < 2 cm in diameter
(3) Child-Pugh grade A
(4) ALBI grade 1
Modified BCLC Stage D - one or more of the following:
(1) ECOG 3 or 4
(2) Child-Pugh C
(3) ALBI grade 3
Modified BCLC Stages A, B and C share:
(1) Child-Pugh A or B
(2) ALBI grade 1 or 2
(3) not stage 0 or D
Modified BCLC Stage C - one or more of the following:
(1) ECOG 1 or 2
(2) vascular invasion or extrahepatic spread
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Tumor Stage
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Modified BCLC
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1 to 3 tumors, all < 3 cm in diameter
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A
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other
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B
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Performance:
• The area under the ROC curve was 0.75.
• The ALBI score was comparable to the Child-Pugh grade for discrimination between overall survival.
