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

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Abstract

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.

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Acknowledgements

This study was supported by the grants from Taipei Veterans General Hospital (V110C-001, VN111-07), Taipei, Taiwan. All the authors declare no conflict of interest.

Author information

Author notes

  1. Chih-Chieh Ko and Shu-Yein Ho have contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Chih-Chieh Ko, Yi-Hsiang Huang, Chien-Wei Su & Ming-Chih Hou

  2. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC

    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

  3. Division of Gastroenterology and Hepatology, Min-Sheng General Hospital, Taoyuan, Taiwan, ROC

    Shu-Yein Ho

  4. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Po-Hong Liu

  5. VA Sierra Nevada Health Care System, Reno, NV, USA

    Chia-Yang Hsu

  6. Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC

    Cheng-Yuan Hsia & Yi-Hsiang Huang

  7. Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Hao-Jan Lei

  8. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Rheun-Chuan Lee

  9. Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei, 11217, Taiwan, ROC

    Teh-Ia Huo

  10. Institute of Pharmacology, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC

    Teh-Ia Huo

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  1. Chih-Chieh Ko
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Contributions

CCK, TIH, and SYH performed the research and wrote the paper. CYH, PHL, CYH, and CWS collected and analyzed the data. HJL, YHH, RCL, and MCH contributed to study design and data collection. All the authors approved the final version of the manuscript.

Corresponding author

Correspondence to Teh-Ia Huo.

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Ko, CC., Ho, SY., Liu, PH. et al. Dual hepatitis B and C-associated hepatocellular carcinoma: clinical characteristics, outcome, and prognostic role of albumin–bilirubin grade. Int J Clin Oncol 27, 739–748 (2022). https://doi.org/10.1007/s10147-022-02117-9

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  • DOI: https://doi.org/10.1007/s10147-022-02117-9

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