Evidence map›Paper›PMID 34505035›Full record

ReviewJHEP reports : innovation in hepatology2021

ALBI grade: Evidence for an improved model for liver functional estimation in patients with hepatocellular carcinoma.

Coskun O Demirtas, Antonio D'Alessio, Lorenza Rimassa, Rohini Sharma, David J Pinato

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 151 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
151citing papers in PubMed, 3 pooled it
19.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

151 citing papers in PubMed, 3 syntheses or guidelines pooled it, 198 citations in OpenAlex.

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  14. From Theory to Practice: Which Biomarkers Are Ready for Predicting Response in Advanced HCC?Liver international : official journal of the International Association for the Study of the Liver · 2026
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91 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 3 countries.

Coskun O DemirtasMarmara University, School of Medicine, Department of Gastroenterology, Istanbul, Turkey.
Antonio D'AlessioDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.
Lorenza RimassaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Rohini SharmaDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.
David J PinatoDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.
Humanitas University · ITHammersmith Hospital · GBMarmara University · TRUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro” · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hepatocellular carcinoma (HCC) usually arises in the context of a chronically damaged liver. Liver functional estimation is of paramount importance in clinical decision making. The Child-Pugh score (CPS) can be used to categorise patients into 3 classes (A to C) based on the severity of liver functional impairment according to 5 parameters (albumin, bilirubin, prothrombin time, presence of ascites and hepatic encephalopathy). The albumin-bilirubin (ALBI) grade has emerged as an alternative, reproducible and objective measure of liver functional reserve in patients with HCC, defining worsening liver impairment across 3 grades (I to III). The ALBI score can identify different subgroups of patients with different prognoses across the diverse Barcelona Clinic Liver Cancer stages and CP classes, making it an appealing clinical predictor. In patients treated with potentially curative approaches (resection, transplantation, radiofrequency ablation, microwave ablation), ALBI grade has been shown to correlate with survival, tumour relapse, and post-hepatectomy liver failure. ALBI grade also predicts survival, toxicity and post-procedural liver failure in patients treated with transarterial chemoembolisation, radioembolisation, external beam radiotherapy as well as multi-kinase inhibitors (sorafenib, lenvatinib, cabozantinib, regorafenib) and immune checkpoint inhibitor therapy. In this review, we summarise the body of evidence surrounding the role of ALBI grade as a biomarker capable of optimising patient selection and therapeutic sequencing in HCC.

Indexed as

ALBI, albumin-bilirubinAPRI, aspartate aminotransferase to platelet count indexBCLC, Barcelona Clinic Liver CancerChild-PughcirrhosisCLD, chronic liver diseaseCPS, Child-Pugh scoreHCCHCC, hepatocellular carcinomaICIs, immune checkpoint inhibitorsliver functionLT, liver transplantationmAb, monoclonal antibodyMELD, model for end-stage liver diseaseORR, objective response rateOS, overall survivalPHLF, post-hepatectomy liver failureprognosisRFS, recurrence-free survivalTACE, transarterial chemoembolisationTARE, transarterial radioembolisation

Identifiers

PMID34505035
PMCPMC8411239
OpenAlexW3191788410

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.