ArticleJournal of clinical medicine2023
Albumin-Globulin Score Combined with Skeletal Muscle Index as a Novel Prognostic Marker for Hepatocellular Carcinoma Patients Undergoing Liver Transplantation.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Pretransplant albumin-to-globulin ratio and long-term outcomes after liver transplantation for hepatocellular carcinoma: a two-center cohort study.Frontiers in oncology · 2026Article
- Development and validation of a machine learning model for predicting hypersplenism in Wilson disease patients.Frontiers in medicine · 2026Article
- Predictive value of combined Albumin-Globulin score and psoas muscle index for postoperative prognosis in combined hepatocellular carcinoma and cholangiocarcinoma.World journal of surgical oncology · 2025Article
- Criteria and prognostic models for patients with hepatocellular carcinoma undergoing liver transplantation.Clinical and molecular hepatology · 2025Review
- The Red Cell Distribution Width to Albumin Ratio: A Novel Prognostic Indicator in Hepatitis B Virus-Related Hepatocellular Carcinoma.International journal of medical sciences · 2025Article
- Imaging-based assessment of muscles and malnutrition predict prognosis in patients with primary hepatocellular carcinoma.PloS one · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundSarcopenia was recently identified as a poor prognostic factor in patients with malignant tumors. The present study investigated the effect of the preoperative albumin-globulin score (AGS), skeletal muscle index (SMI), and combination of AGS and SMI (CAS) on short- and long-term survival outcomes following deceased donor liver transplantation (DDLT) for hepatocellular carcinoma (HCC) and aimed to identify prognostic factors.
methodsA total of 221 consecutive patients who underwent DDLT for HCC were enrolled in this retrospective study between January 2015 and December 2019. The skeletal muscle cross-sectional area was measured by CT (computed tomography). Clinical cutoffs of albumin (ALB), globulin (GLB), and sarcopenia were defined by receiver operating curve (ROC). The effects of the AGS, SMI, and CAS grade on the preoperative characteristics and long-term outcomes of the included patients were analyzed.
resultsPatients who had low AGS and high SMI were associated with better overall survival (OS) and recurrence-free survival (RFS), shorter intensive care unit (ICU) stay, and fewer postoperative complications (grade ≥ 3, Clavien-Dindo classification). Stratified by CAS grade, 46 (20.8%) patients in grade 1 were associated with the best postoperative prognosis, whereas 79 (35.7%) patients in grade 3 were linked to the worst OS and RFS. The CAS grade showed promising accuracy in predicting the OS and RFS of HCC patients [areas under the curve (AUCs) were 0.710 and 0.700, respectively]. Male recipient, Child-Pugh C, model for end-stage liver disease (MELD) score > 20, and elevated CAS grade were identified as independent risk factors for OS and RFS of HCC patients after DDLT.
conclusionCAS grade, a novel prognostic index combining preoperative AGS and SMI, was closely related to postoperative short-term and long-term outcomes for HCC patients who underwent DDLT. Graft allocation and clinical decision making may be referred to CAS grade evaluation.
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