TY - JOUR
T1 - Reliable Performance of mALBI Grade-Based Risk Models for Predicting the Prognosis of Patients With Hepatocellular Carcinoma Receiving Atezolizumab Plus Bevacizumab as First-Line Treatment
T2 - Comparative Analysis of 13 Risk Models
AU - the Real-life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
AU - Hatanaka, Takeshi
AU - Kakizaki, Satoru
AU - Hiraoka, Atsushi
AU - Tada, Toshifumi
AU - Hirooka, Masashi
AU - Kariyama, Kazuya
AU - Tani, Joji
AU - Atsukawa, Masanori
AU - Takaguchi, Koichi
AU - Itobayashi, Ei
AU - Fukunishi, Shinya
AU - Tsuji, Kunihiko
AU - Ishikawa, Toru
AU - Tajiri, Kazuto
AU - Toyoda, Hidenori
AU - Ogawa, Chikara
AU - Nishikawa, Hiroki
AU - Nishimura, Takashi
AU - Kawata, Kazuhito
AU - Kosaka, Hisashi
AU - Naganuma, Atsushi
AU - Yata, Yutaka
AU - Ohama, Hideko
AU - Kuroda, Hidekatsu
AU - Matono, Tomomitsu
AU - Tanaka, Kazunari
AU - Tada, Fujimasa
AU - Nouso, Kazuhiro
AU - Morishita, Asahiro
AU - Tsutsui, Akemi
AU - Nagano, Takuya
AU - Itokawa, Norio
AU - Okubo, Tomomi
AU - Arai, Taeang
AU - Imai, Michitaka
AU - Koizumi, Yohei
AU - Nakamura, Shinichiro
AU - Kaibori, Masaki
AU - Iijima, Hiroko
AU - Hiasa, Yoichi
AU - Kumada, Takashi
N1 - Publisher Copyright:
© 2025 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
PY - 2025/4
Y1 - 2025/4
N2 - Aim: This study aimed to compare the prognostic performance of the risk models for patients with hepatocellular carcinoma (HCC) receiving atezolizumab and bevacizumab (Atez/Bev) as first-line treatment. Methods: Among 449 patients included in this retrospective multicenter study, we compared the prognostic performance of 13 risk models for the 12-month and 18-month survival status using area under the curve (AUC), net reclassification improvement (NRI), and relative integrated discrimination improvement (IDI) analysis. We also constructed a calibration plot to assess the fitness of each model. Results: Regarding the analysis of the 12-month survival status, none of the risk models demonstrated AUC values higher than the modified albumin-bilirubin (mALBI) grade. In the NRI analysis, only the IMmunotherapy with AFP, BCLC staging, mALBI, and DCP evaluation (IMABALI-De score) exhibited a statistically significant improvement compared with the mALBI grade (p = 0.009). While the modified albumin-bilirubin grade (mALF) score and prognostic nutritional index (PNI) did not exhibit significant differences compared to the mALBI grade (p = 0.3 and 0.2, respectively), the remaining risk models were inferior to the mALBI grade. In the relative IDI analysis, none of the risk models showed a significant improvement compared with the mALBI grade. The calibration plot of the PNI was unsatisfactory. The results for the 18-month survival status were consistent with those for the 12-month survival status. A time-dependent ROC analysis demonstrated that both the mALBI grade and the mALBI-based model showed consistent performance over time. Conclusions: The mALBI grade, as well as the IMABALI-De and mALF scores (both of which are risk models based on mALBI grade), exhibited reliable performance in predicting the prognosis of patients with HCC.
AB - Aim: This study aimed to compare the prognostic performance of the risk models for patients with hepatocellular carcinoma (HCC) receiving atezolizumab and bevacizumab (Atez/Bev) as first-line treatment. Methods: Among 449 patients included in this retrospective multicenter study, we compared the prognostic performance of 13 risk models for the 12-month and 18-month survival status using area under the curve (AUC), net reclassification improvement (NRI), and relative integrated discrimination improvement (IDI) analysis. We also constructed a calibration plot to assess the fitness of each model. Results: Regarding the analysis of the 12-month survival status, none of the risk models demonstrated AUC values higher than the modified albumin-bilirubin (mALBI) grade. In the NRI analysis, only the IMmunotherapy with AFP, BCLC staging, mALBI, and DCP evaluation (IMABALI-De score) exhibited a statistically significant improvement compared with the mALBI grade (p = 0.009). While the modified albumin-bilirubin grade (mALF) score and prognostic nutritional index (PNI) did not exhibit significant differences compared to the mALBI grade (p = 0.3 and 0.2, respectively), the remaining risk models were inferior to the mALBI grade. In the relative IDI analysis, none of the risk models showed a significant improvement compared with the mALBI grade. The calibration plot of the PNI was unsatisfactory. The results for the 18-month survival status were consistent with those for the 12-month survival status. A time-dependent ROC analysis demonstrated that both the mALBI grade and the mALBI-based model showed consistent performance over time. Conclusions: The mALBI grade, as well as the IMABALI-De and mALF scores (both of which are risk models based on mALBI grade), exhibited reliable performance in predicting the prognosis of patients with HCC.
KW - ALBS grade
KW - CRAFITY score
KW - geriatric nutritional risk index
KW - Glasgow prognostic score
KW - HCC-GRIm score
KW - IMABALI-De score
KW - mALF score
KW - neo-GPS
KW - neutrophil to lymphocyte ratio
KW - prognostic nutritional index
UR - http://www.scopus.com/inward/record.url?scp=105002136282&partnerID=8YFLogxK
U2 - 10.1111/jgh.16871
DO - 10.1111/jgh.16871
M3 - 学術論文
C2 - 39762722
AN - SCOPUS:105002136282
SN - 0815-9319
VL - 40
SP - 930
EP - 939
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 4
ER -