Skip to main content

Advertisement

SpringerLink
Log in

A discussion of serum albumin level in advanced-stage hepatocellular carcinoma: a medical oncologist’s perspective

  • Short Communication
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Hepatocellular carcinoma is the most common primary malignant tumor of the liver, and it is particularly prevalent in East and Southeast Asia. With surgical and/or local interventional treatment methods, survival rates for early-stage hepatocellular cancers have increased. However, it is not yet clear which staging systems are more applicable in hepatocellular carcinoma. Serum albumin level is already being used as a criterion in most staging systems. Albumin is an important serum protein in human bodily functions, but only 5 % of the daily amount needed is synthesized by the liver. The serum albumin level is affected by multifactorial situations, including capillary permeability, drugs, liver insufficiency, inflammation and/or infections, dehydration or overhydration, protein loosing disorders, and decreased nutrition intake in anorexia-malnutrition syndrome and cancer cachexia. Because of this complex situation, serum albumin level may affect many staging systems for hepatocellular carcinoma by leading to false-negative results. In this paper, the statuses of current staging systems are reviewed, and possible negative events regarding the serum albumin levels found in these staging systems are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29.

    Article  PubMed  Google Scholar 

  2. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–76.

    Article  PubMed  CAS  Google Scholar 

  3. Sirivatanauksorn Y, Tovikkai C. Comparison of staging systems of hepatocellular carcinoma. HPB Surg. 2011;2011(818217):7. doi:10.1155/2011/818217.

    Google Scholar 

  4. Nathan H, Mentha G, Marques HP, Capussotti L, Majno P, et al. Comparative performances of staging systems for early hepatocellular carcinoma. HPB. 2009;11:382–90.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sameer P, Hyman D. Hepatocellular carcinoma: a guide for the internist. Am J Med. 2007;120:194–202.

    Article  Google Scholar 

  6. Henderson JM, Sherman M, Tavill A, Abecassis M, Chejfec G, et al. AHPBA/AJCC consensus conference on staging of hepatocellular carcinoma: consensus statement. HPB. 2003;5:243–50.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Okuda K, Ohtsuki T, Obata H, Tomimatsu N, Okzaki N, et al. Natural history of hepatocellular carcinoma and prognosis in relation to treatment: study of 850 patients. Cancer. 1985;56:918–28.

    Article  PubMed  CAS  Google Scholar 

  8. The Cancer of the Liver Italian Program. (CLIP) Investigators. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology. 1998;28:751–5.

    Article  Google Scholar 

  9. Llovet JM, Bruix J. Prospective validation of the Cancer of the Liver Italian Program (CLIP) score: a new prognostic system for patients with cirrhosis and hepatocellular carcinoma. Hepatology. 2000;32:679–80.

    Article  PubMed  CAS  Google Scholar 

  10. Chevret S, Trinchet JC, Mathieu D, Rached AA, Beaugrand M, et al. A new prognostic classification for predicting survival in patients with hepatocellular carcinoma. J Hepatol. 1999;31:133–41.

    Article  PubMed  CAS  Google Scholar 

  11. Leung TWT, Tang AMY, Zee B, Lau WY, Lai PB, et al. Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study of 926 patients. Cancer. 2002;94:1760–9.

    Article  PubMed  Google Scholar 

  12. Kudo M, Chung H, Osaki Y. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging score (JIS score). J Gastroenterol. 2003;38:207–15.

    Article  PubMed  Google Scholar 

  13. Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19:329–38.

    Article  PubMed  CAS  Google Scholar 

  14. Minagawa M, Ikai I, Matsuyama Y, Yamaoka Y, Makuuchi M. Staging of hepatocellular carcinoma: assessment of the Japanese TNM and AJCC/UICC TNM systems in a cohort of 13,772 patients in Japan. Ann Surg. 2007;245:909–22.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kitai S, Kudo M, Minami Y, Ueshima K, Chung H, et al. A new prognostic staging system for hepatocellular carcinoma: value of the biomarker combined Japan Integrated Staging score. Intervirology. 2008;5(Supp 1):86–94.

    Article  Google Scholar 

  16. Omagari K, Honda S, Kadokawa Y, Isomoto H, Takeshima F, et al. Preliminary analysis of a newly proposed prognostic scoring system (SLiDe score) for hepatocellular carcinoma. J Gastroenterol Hepatol. 2004;19:805–11.

    Article  PubMed  Google Scholar 

  17. Toyoda H, Kumada T, Osaki Y, Oka H, Urano F, et al. Staging hepatocellular carcinoma by a novel scoring system (BALAD score) based on serum markers. Clin Gastroenterol Hepatol. 2006;4:1528–36.

    Article  PubMed  CAS  Google Scholar 

  18. Tateishi R, Yoshida H, Shiina S, Imamura H, Hasegawa K, et al. Proposal of a new prognostic model for hepatocellular carcinoma: an analysis of 403 patients. Gut. 2005;54:419–25.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  19. Yau T, Yao TJ, Chan P, Ng K, Fan ST, et al. A new prognostic score system in patients with advanced hepatocellular carcinoma not amendable to locoregional therapy: implication for patient selection in systemic therapy trials. Cancer. 2008;113:2742–51.

    Article  PubMed  Google Scholar 

  20. Ruot B, Breuille D, Rambourdin F, Bayle G, Capitan P, et al. Synthesis rate of plasma albumin is a good indicator of liver albumin synthesis in sepsis. Am J Physiol Endocrinol Metab. 2000;279:E244–51.

    PubMed  CAS  Google Scholar 

  21. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17:432–7.

    Article  PubMed  Google Scholar 

  23. Marrero JA, Kudo M, Bronowicki JP. The challenge of prognosis and staging for hepatocellular carcinoma. Oncologist. 2010;15:23–33.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Faculty of Medicine, Sitki Kocman University, Mugla, Turkey

    Ozgur Tanriverdi

Authors
  1. Ozgur Tanriverdi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ozgur Tanriverdi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tanriverdi, O. A discussion of serum albumin level in advanced-stage hepatocellular carcinoma: a medical oncologist’s perspective. Med Oncol 31, 282 (2014). https://doi.org/10.1007/s12032-014-0282-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-014-0282-3

Keywords

Search

Navigation