ArticleJournal of hepatocellular carcinoma2025
The Combined ALBI-FIB-4 Score for Prognostic Stratification in Hepatocellular Carcinoma: A Single Center Retrospective Study.
Article in Journal of hepatocellular carcinoma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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12 authors.
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Abstract
Background: Hepatocellular carcinoma (HCC) is influenced not only by tumor burden but also by liver function and the extent of fibrosis. Although the albumin-bilirubin (ALBI) score and the fibrosis-4 (FIB-4) index are validated independent predictors, their combined prognostic impact has been insufficiently examined. Methods: We retrospectively analyzed 307 patients with HCC diagnosed between 2002 and 2025. ALBI and FIB-4 scores were calculated at baseline, and a composite score was generated using the β-coefficients obtained from a multivariable Cox regression model, allowing each component to contribute proportionally to its prognostic weight (combined score = 0.503 × ALBI + 0.0576 × FIB-4). Patients were stratified using the median cutoff value (-0.95). Outcomes included overall survival (OS), event-free survival (EFS) for those undergoing locoregional therapies, and progression-free survival (PFS) for patients treated with systemic therapy. Results: Median OS was 12.1 months. Patients with combined scores ≤-0.95 had superior OS (18.3 vs 6.8 months, p < 0.001), and the score remained an independent predictor of OS (HR 2.01, 95% CI 1.48-2.72, p = 0.001). In the locoregional therapy group, lower scores predicted improved EFS (16.4 vs 5.8 months,: HR:1.86; 95% CI:1.17-2.96; p=0.009). Among systemic therapy patients, the combined score independently predicted PFS (HR 1.70, 95% CI 1.21-2.41, p = 0.021). Conclusion: The combined ALBI-FIB-4 score is an accessible and reproducible prognostic marker across therapeutic settings in HCC. By integrating measures of hepatic reserve and fibrosis, it provides additional prognostic granularity beyond tumor-centric staging systems. These findings highlight its potential utility in personalized risk stratification and warrant validation in prospective, multi-ethnic cohorts.
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