_id

683a162ec782e11e38d1b250

id

10070

title

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

full_title

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

short_title

ALBI Grade for HCC

med_description

Predicts survival in HCC patients.

short_description

HCC survival.

slug

albi-albumin-bilirubin-grade-hepatocellular-carcinoma-hcc

description

The ALBI (Albumin-Bilirubin) Grade for Hepatocellular Carcinoma (HCC) predicts survival in HCC patients.

keywords

Albumin, bilirubin, liver function, liver dysfunction, HCC survival, C-P grade, Child-Pugh grade

complaint

[ "Abdominal Pain", "Jaundice" ]

formula

ALBI = (log10bilirubin × 0.66) + (albumin × -0.085), where bilirubin is in μmol/L and albumin in g/L.

evidence

measurements

[ { "name": "Bilirubin", "unit": "bili", "error_min": "1E-8", "error_max": "50", "warn_min": "0", "warn_max": "20", "conversion": "17.104", "normal_max_si": "32.49", "normal_max_us": "1.9", "normal_min_si": "5.13", "normal_min_us": "0.3", "units_si": "µmol/L", "units_us": "mg/dL" }, { "name": "Albumin (General)", "unit": "alb", "error_min": "0", "error_max": "7", "warn_min": "1", "warn_max": "6", "conversion": "10", "normal_max_si": "55", "normal_max_us": "5.5", "normal_min_si": "35", "normal_min_us": "3.5", "units_si": "g/L", "units_us": "g/dL" } ]

information

Interpretation:

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/25512453", "text": "Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol. 2015;33(6):550-8." } ], "Other References": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/28626732", "text": "Hiraoka A, Kumada T, Kudo M, et al. Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications. Liver Cancer. 2017;6(3):204-215." } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/29234636 ", "text": "Hiraoka A, Michitaka K, Kumada T, et al. Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function. Liver Cancer. 2017;6(4):325-336." }, { "href": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478326/", "text": "Chen B, Lin S. Albumin-bilirubin (ALBI) score at admission predicts possible outcomes in patients with acute-on-chronic liver failure. Medicine (Baltimore). 2017;96(24):e7142." }, { "href": "https://onlinelibrary.wiley.com/doi/full/10.1111/liv.13527", "text": "Lee PC, Chen YT, Chao Y, et al. Validation of the albumin-bilirubin grade-based integrated model as a predictor for sorafenib-failed hepatocellular carcinoma. Liver Int. 2018;38(2):321-330." } ], "Validations": [] }

pearls

• 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).

usecase

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

reasons

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 theChild-Pugh Scorethat excludes subjective elements (e.g., encephalopathy).

next_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.

next_actions

next_management

diseases

[ "Hepatocellular Carcinoma" ]

input_schema

[ { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Bilirubin", "name": "bilirubin", "optional": false, "tips_en": "", "type": "textbox", "unit": "bili" }, { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Albumin", "name": "albumin", "optional": false, "tips_en": "", "type": "textbox", "unit": "alb" } ]

instructions

published

2022-04-21T20:28:13.780Z

purpose

[ "Prognosis" ]

search_terms

[ "Albi score" ]

seo

{ "keywords_en": "Albumin, bilirubin, liver function, liver dysfunction, HCC survival, C-P grade, Child-Pugh grade", "meta_description_en": "The ALBI (Albumin-Bilirubin) Grade for Hepatocellular Carcinoma (HCC) predicts survival in HCC patients." }

specialty

[ "Gastroenterology", "Hematology and Oncology", "Hepatology", "Hospitalist Medicine", "Internal Medicine" ]

departments

[ "Gastrointestinal", "Oncologic" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 340, "short_title_en": "Child-Pugh Score", "slug": "child-pugh-score-cirrhosis-mortality" }, { "calcId": 10147, "short_title_en": "UKELD Score", "slug": "united-kingdom-model-end-stage-liver-disease-ukeld" }, { "calcId": 10240, "short_title_en": "CLIF-C ACLF", "slug": "clif-c-aclf-acute-chronic-liver-failure" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "gastroenterology", "oncology" ]

cleaned_use

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

pub

false