ALBI (Albumin-Bilirubin) Grade for Hepatocellular Carcinoma (HCC)

Why Use

Provides an objective, validated measure of liver function based solely on albumin and bilirubin levels. Correlates with overall survival, making it useful for staging and prognostic assessments in HCC. Non-invasive and simple to calculate. Offers an alternative to the Child-Pugh Score that excludes subjective elements (e.g., encephalopathy).

When to Use

Use in patients with hepatocellular carcinoma (HCC) to assess liver function and prognosis.

Formula

Pearls / Pitfalls

Does not account for all aspects of liver function, such as the presence of portal hypertension, which may still influence clinical decisions. May overestimate liver dysfunction in patients with conditions affecting albumin independently of liver function (e.g., malnutrition).

Advice

Management of HCC depends on multiple factors, including tumor characteristics, comorbidities, underlying liver function, and availability/experience with certain therapeutic procedures. Consider a multidisciplinary approach (e.g., hepatologist, oncologist, surgeon) based on ALBI grade and the overall clinical picture. Low grade (Grade 1): Suggests preserved liver function. The patient may be a candidate for more aggressive treatment options, including surgical resection and/or transcatheter arterial chemoembolization (TACE). Higher grades (Grade 2 or 3): Indicates worse liver function. Depending on the clinical picture, some patients may not be candidates for certain therapeutic procedures. Select patients may be appropriate for transplant.

More Information

Interpretation: ALBI Score Grade Median survival ≤-2.60 1 18.5-85.6 months >-2.60 to ≤-1.39 2 5.3-46.5 months >-1.39 3 2.3-15.5 months