Dual hepatitis B and C-associated hepatocellular carcinoma: clinical characteristics, outcome, and prognostic role of albumin–bilirubin grade

Chih Chieh Ko, Shu Yein Ho, Po Hong Liu, Chia Yang Hsu, Cheng Yuan Hsia, Yi-Hsiang Huang, Chien Wei Su, Hao Jan Lei, Rheun Chuan Lee, Ming Chih Hou, Teh Ia Huo*

*此作品的通信作者

研究成果: Article同行評審

摘要

Background: Albumin–bilirubin (ALBI) grade is used to evaluate the outcome of patients with hepatocellular carcinoma (HCC) which is often associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study aimed to investigate the clinical characteristics, outcome, and prognostic role of ALBI grade in dual HBV/HCV-related HCC. Methods: A total 3341 HCC patients with viral etiology were prospectively enrolled and retrospectively analyzed. Multivariate Cox proportional hazards model was used to identify independent prognostic predictors. Results: Of all patients, 2083 (62%), 1068 (32%), and 190 (6%) patients had HBV, HCV, and dual HBV/HCV infection, respectively. The mean age of HBV, HCV, and dual virus group was 60, 68, and 64 years (p < 0.001), respectively. There was no significant survival difference between HBV, HCV, and dual HBV/HCV-related HCC group (p = 0.712). Multivariate Cox analysis in dual HBV/HCV-related HCC showed that multiple tumors [hazard ratio (HR): 1.537, p = 0.044], tumor size >3 cm (HR 2.014, p = 0.044), total tumor volume (TTV) >50 cm3 (HR 3.050, p < 0.001), vascular invasion (HR 3.258, p < 0.001), performance status 2–4 (HR 2.232, p < 0.001), ALBI grade 2–3 (HR 2.177, p < 0.001), and BCLC stage B–D (HR 2.479, p < 0.001) were independent predictors of poor survival. Conclusions: Dual viral infection does not accelerate the development of HCC in HBV carriers. Patient survival is similar between dual HBV/HCV-related HCC and single HBV- or HCV-related HCC group. The ALBI grade is a robust prognostic model in dual virus-related HCC to discriminate patient long-term survival.

原文English
期刊International Journal of Clinical Oncology
DOIs
出版狀態Accepted/In press - 2022

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