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Hepatocellular Carcinoma Treatment and Prognosis · Journal article
BMC Gastroenterology · August 12, 2026
Reinforces what was already believed, rather than introducing something new.
This retrospective cohort study of 642 treatment-naïve HCC patients undergoing TACE demonstrates that combined NLR and ALBI grade independently predict overall survival and modestly improve prognostic discrimination compared to either marker alone. The combination achieved an AUC of 0.645, a modest improvement over ALBI alone (0.610) or NLR alone (0.576), and identifies a high-risk subgroup with both elevated NLR and impaired liver function.
Retrospective cohort study. Treatment-naïve patients with hepatocellular carcinoma (HCC) who received TACE as first-line therapy.. Intervention: Transarterial chemoembolization (TACE) as first-line therapy. n = 642.
Multivariable analysis identified ALBI grade (HR 1.630, 95% CI 1.248–2.128; P < 0.001) and NLR (HR 1.623, 95% CI 1.195–2.205; P = 0.002) as independent OS predictors Combined NLR and ALBI grade AUC 0.645 versus ALBI alone AUC 0.610 or NLR alone AUC 0.576 Patients with both elevated NLR and impaired liver function had significantly poorer survival than all other subgroups (P < 0.001)
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Clinicians managing HCC patients treated with TACE may use the combined NLR and ALBI grade to improve risk stratification and prognostic counselling. The modest discriminatory gain and reliance on readily available laboratory markers make this a complementary rather than definitive prognostic tool, particularly useful for identifying high-risk patients with both elevated NLR and impaired liver function.
Retrospective cohort study confirming that combined NLR and ALBI grade moderately improve prognostic discrimination in HCC treated with TACE, with clear multivariable analysis but modest effect size and no practice-changing threshold.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians managing HCC patients treated with TACE may use the combined NLR and ALBI grade to improve risk stratification and prognostic counselling. The modest discriminatory gain and reliance on readily available laboratory markers make this a complementary rather than definitive prognostic tool, particularly useful for identifying high-risk patients with both elevated NLR and impaired liver function.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Clinical outcomes after transarterial chemoembolization (TACE) vary considerably among patients with hepatocellular carcinoma (HCC), reflecting the heterogeneity of both tumor biology and underlying liver function. Although systemic inflammatory markers and liver functional reserve have individually been associated with prognosis, the clinical utility of their combined assessment remains unclear. We investigated the prognostic value of combining the neutrophil-to-lymphocyte ratio (NLR) and albumin-bilirubin (ALBI) grade in treatment-naïve patients with HCC undergoing initial TACE. We retrospectively analyzed 642 treatment-naïve patients with HCC who received TACE as first-line therapy. Overall survival (OS) was evaluated using the Kaplan–Meier method and Cox proportional hazards regression. Independent prognostic factors were identified by multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to compare the prognostic performance of NLR, ALBI grade, and their combination. During a median OS duration of 41 months, 485 patients (75.5%) died. Multivariable analysis identified Barcelona Clinic Liver Cancer (BCLC) stage (HR 2.070, 95% CI 1.477–2.902; P < 0.001), ALBI grade (HR 1.630, 95% CI 1.248–2.128; P < 0.001), and NLR (HR 1.623, 95% CI 1.195–2.205; P = 0.002) as independent predictors of OS. The combination of ALBI grade and NLR demonstrated modestly improved prognostic discrimination (AUC 0.645) compared with ALBI grade alone (AUC 0.610) or NLR alone (AUC 0.576). Patients with both elevated NLR and impaired liver function exhibited significantly poorer long-term survival than all other subgroups ( P < 0.001). The combination of ALBI grade and NLR provides a simple and readily available prognostic tool that integrates liver functional reserve and systemic inflammatory status. This combined marker improves risk stratification and may serve as a complementary tool for prognostic assessment and clinical decision-making.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.