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Objectives <p>To evaluate the efficacy of the albumin-bilirubin (ALBI) grade, easy albumin-bilirubin (EZ-ALBI) grade and sarcopenia in predicting the prognosis of patients with unresectable hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) as monotherapy or in combination with Lenvatinib.</p> Methods <p>Thirty-eight patients with Barcelona Clinic Liver Cancer (BCLC) stage B and 36 patients with stage C HCC received TACE and TACE with Lenvatinib, respectively. Tumor response was assessed according to the modified RECIST (mRECIST) criteria. ALBI, EZ-ALBI grades and sarcopenia were measured both prior to TACE and during follow-up. Prognostic outcomes were determined based on objective response rate (ORR), progression rate and progression-free survival (PFS). Appropriate statistical analyses were used; <i>p</i> &lt; 0.05 was considered significant.</p> Results <p>In stage B, ORR, tumor progression and PFS showed significant variation with ALBI grades (<i>p</i> = 0.004, <i>p</i> = 0.001, <i>p</i> &lt; 0.001), but not with sarcopenia (<i>p</i> = 0.090, <i>p</i> = 0.310, <i>p </i>= 0.114). ORR exhibited no significant difference across EZ-ALBI grades (<i>p</i> = 0.055), whereas tumor progression and PFS demonstrated significant differences (<i>p</i> = 0.025, <i>p</i> = 0.004). In stage C, ORR, tumor progression and PFS varied significantly according to ALBI grades (<i>p</i> = 0.011, <i>p</i> = 0.002, <i>p</i> &lt; 0.001) and were worse in patients with sarcopenia (<i>p</i> = 0.006, <i>p</i> = 0.039, <i>p</i> = 0.012). Although ORR did not differ significantly across EZ-ALBI grades (<i>p</i> = 0.158), tumor progression and PFS showed significant differences (<i>p</i> = 0.033 and <i>p</i> &lt; 0.001).</p> Conclusions <p>ALBI and EZ-ALBI grades demonstrated significant prognostic value for patients with intermediate-stage HCC undergoing TACE, as well as for those with advanced-stage HCC receiving TACE in combination with Lenvatinib. The presence of sarcopenia correlated with a poorer prognosis and diminished response in patients with advanced HCC treated with TACE and Lenvatinib; however, no definitive association was identified in patients classified as BCLC stage B following TACE.</p> Graphical Abstract <p></p>

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Albumin-bilirubin grade and sarcopenia as predictors of prognosis in patients with unresectable intermediate and advanced-stage hepatocellular carcinoma

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Biswajit Sahoo,
  • Jagabandhu Hembram,
  • Manas Kumar Panigrahi,
  • Sourav Kumar Mishra,
  • Sandip Kumar Barik,
  • Saroj Kumar Das Majumdar,
  • Hemanta Kumar Nayak,
  • Manoj Kumar Nayak,
  • Phanindra Kumar Swain,
  • Arunprakash Pitchaimuthu,
  • Suprava Naik,
  • Dillip Kumar Muduly,
  • Kiran YGL,
  • Shilpy Jha,
  • Priyadip Maiti,
  • Subhabrata Biswal

摘要

Objectives

To evaluate the efficacy of the albumin-bilirubin (ALBI) grade, easy albumin-bilirubin (EZ-ALBI) grade and sarcopenia in predicting the prognosis of patients with unresectable hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) as monotherapy or in combination with Lenvatinib.

Methods

Thirty-eight patients with Barcelona Clinic Liver Cancer (BCLC) stage B and 36 patients with stage C HCC received TACE and TACE with Lenvatinib, respectively. Tumor response was assessed according to the modified RECIST (mRECIST) criteria. ALBI, EZ-ALBI grades and sarcopenia were measured both prior to TACE and during follow-up. Prognostic outcomes were determined based on objective response rate (ORR), progression rate and progression-free survival (PFS). Appropriate statistical analyses were used; p < 0.05 was considered significant.

Results

In stage B, ORR, tumor progression and PFS showed significant variation with ALBI grades (p = 0.004, p = 0.001, p < 0.001), but not with sarcopenia (p = 0.090, p = 0.310, p = 0.114). ORR exhibited no significant difference across EZ-ALBI grades (p = 0.055), whereas tumor progression and PFS demonstrated significant differences (p = 0.025, p = 0.004). In stage C, ORR, tumor progression and PFS varied significantly according to ALBI grades (p = 0.011, p = 0.002, p < 0.001) and were worse in patients with sarcopenia (p = 0.006, p = 0.039, p = 0.012). Although ORR did not differ significantly across EZ-ALBI grades (p = 0.158), tumor progression and PFS showed significant differences (p = 0.033 and p < 0.001).

Conclusions

ALBI and EZ-ALBI grades demonstrated significant prognostic value for patients with intermediate-stage HCC undergoing TACE, as well as for those with advanced-stage HCC receiving TACE in combination with Lenvatinib. The presence of sarcopenia correlated with a poorer prognosis and diminished response in patients with advanced HCC treated with TACE and Lenvatinib; however, no definitive association was identified in patients classified as BCLC stage B following TACE.

Graphical Abstract