Validation of Modified Albumin-Bilirubin-Tumor Stage as a Prognostic Model in Early-Stage Hepatocellular Carcinoma Treated With Radiofrequency Ablation.
- 1Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
- 2Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan.
- 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jen-Ai Hospital, Taichung City, Taiwan.
Abstract
Survival after radiofrequency ablation (RFA) for very early- or early-stage hepatocellular carcinoma (HCC) remains heterogeneous because prognosis depends on both tumor burden and hepatic reserve. We retrospectively evaluated treatment-naive patients with Barcelona Clinic Liver Cancer (BCLC) Stages 0 or A HCC treated with RFA as initial therapy from January 2002 to September 2016. Patients with Child-Pugh class A or B and complete ablation were included. Four prespecified total scores, Child-Pugh-tumor (CP-T), albumin-bilirubin-tumor (ALBI-T), modified ALBI-tumor (mALBI-T), and platelet-ALBI-tumor (pALBI-T) were compared using the Akaike information criterion (AIC), Harrell concordance index (C-index), time-dependent area under the receiver operating characteristic curve, calibration, and subgroup analyses. Of 1238 patients screened, 950 were included; 831 (87.5%) were Child-Pugh class A. During a median follow-up of 5.44 years, 417 deaths occurred; 5- and 10-year overall survival rates were 58.0% and 35.8%, respectively. The American Joint Committee on Cancer eighth-edition T stage illustrated the best tumor-stage performance and was used in the total scores, while mALBI-T had the lowest AIC (5052.2) and highest Harrell C-index (0.628; 95% confidence interval, 0.601-0.655). Paired bootstrap differences versus CP-T, ALBI-T, and pALBI-T were statistically significant, but modest, while mALBI-T performed best at 5 years and in Child-Pugh class A patients, whereas all models showed limited discrimination in Child-Pugh class B patients. Apparent calibration was generally close, and mALBI-T also had the best fit for recurrence-free survival. mALBI-T provides a simple prognostic model for long-term survival stratification after complete ablation in early-stage hepatocellular carcinoma, especially in Child-Pugh class A patients.
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BibTeX
@article{hsieh2026validation,
title = {{Validation of Modified Albumin-Bilirubin-Tumor Stage as a Prognostic Model in Early-Stage Hepatocellular Carcinoma Treated With Radiofrequency Ablation.}},
author = {Cheng-Ying Hsieh and Wen-Shuo Yeh and Yi-Hao Yen and Yuan-Hung Kuo and Ming-Chao Tsai and Sheng-Nan Lu and Chao-Hung Hung and Jing-Houng Wang and Chien-Hung Chen and Kwong-Ming Kee},
journal = {The Kaohsiung journal of medical sciences},
year = {2026},
month = nov,
doi = {10.1002/kjm2.70313},
url = {https://europepmc.org/article/MED/42972854},
note = {CC BY},
}
RIS
TY - JOUR
TI - Validation of Modified Albumin-Bilirubin-Tumor Stage as a Prognostic Model in Early-Stage Hepatocellular Carcinoma Treated With Radiofrequency Ablation.
AU - Cheng-Ying Hsieh
AU - Wen-Shuo Yeh
AU - Yi-Hao Yen
AU - Yuan-Hung Kuo
AU - Ming-Chao Tsai
AU - Sheng-Nan Lu
AU - Chao-Hung Hung
AU - Jing-Houng Wang
AU - Chien-Hung Chen
AU - Kwong-Ming Kee
PY - 2026
DA - 2026/11/02
JO - The Kaohsiung journal of medical sciences
DO - 10.1002/kjm2.70313
UR - https://europepmc.org/article/MED/42972854
AB - Survival after radiofrequency ablation (RFA) for very early- or early-stage hepatocellular carcinoma (HCC) remains heterogeneous because prognosis depends on both tumor burden and hepatic reserve. We retrospectively evaluated treatment-naive patients with Barcelona Clinic Liver Cancer (BCLC) Stages 0 or A HCC treated with RFA as initial therapy from January 2002 to September 2016. Patients with Child-Pugh class A or B and complete ablation were included. Four prespecified total scores, Child-Pugh-tumor (CP-T), albumin-bilirubin-tumor (ALBI-T), modified ALBI-tumor (mALBI-T), and platelet-ALBI-tumor (pALBI-T) were compared using the Akaike information criterion (AIC), Harrell concordance index (C-index), time-dependent area under the receiver operating characteristic curve, calibration, and subgroup analyses. Of 1238 patients screened, 950 were included; 831 (87.5%) were Child-Pugh class A. During a median follow-up of 5.44 years, 417 deaths occurred; 5- and 10-year overall survival rates were 58.0% and 35.8%, respectively. The American Joint Committee on Cancer eighth-edition T stage illustrated the best tumor-stage performance and was used in the total scores, while mALBI-T had the lowest AIC (5052.2) and highest Harrell C-index (0.628; 95% confidence interval, 0.601-0.655). Paired bootstrap differences versus CP-T, ALBI-T, and pALBI-T were statistically significant, but modest, while mALBI-T performed best at 5 years and in Child-Pugh class A patients, whereas all models showed limited discrimination in Child-Pugh class B patients. Apparent calibration was generally close, and mALBI-T also had the best fit for recurrence-free survival. mALBI-T provides a simple prognostic model for long-term survival stratification after complete ablation in early-stage hepatocellular carcinoma, especially in Child-Pugh class A patients.
SN - 1607-551X
SN - 2410-8650
ER -