Integration of ALBI Score into Barcelona Clinic Liver Cancer (BCLC) Staging System

Abstract

Background: Hepatocellular carcinoma (HCC) is a major world health concern with a high mortality rate. liver function assessment is important for appropriate staging and treatment strategy. The Albumin-Bilirubin (ALBI) score offers a simpler, more objective alternative to the Child-Turcotte-Pugh (CTP) score for assessing liver function in hepatocellular carcinoma (HCC) patients within the Barcelona Clinic Liver Cancer (BCLC) staging system. The study aims to evaluate the concordance between ALBI- and CTP based BCLC staging in HCC patients.

Material and Methods: A prospective study was conducted from September 2021 to February 2022 at the Centre for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi, Pakistan. 93 HCC patients, diagnosed via triphasic CT per EASL guidelines, were enrolled using convenience sampling. ALBI and CTP scores were calculated, and their integration into BCLC staging was compared using Cohen’s kappa (κ). Data were analyzed with IBM SPSS Statistics v22.0.

Results: Among 93 patients (72% male, mean age 60.16 ± 8.47 years), 61% had multifocal lesions, and 88% had chronic hepatitis C. Cohen’s κ showed near-perfect agreement between ALBI-based and CTP-based BCLC staging (κ = 0.97, p < 0.001), with disagreement in only two patients. ALBI’s objectivity and simplicity enhanced its clinical utility.

Conclusion: This study concludes that ALBI score is a reliable, objective alternative to the CTP score in BCLC staging regarding liver function., offering comparable prognostic performance with greater ease of use. Larger, multicenter studies are needed to validate these findings and assess survival outcomes. The medical community, researchers, and research organizations might all benefit from these findings.