Albumin-bilirubin score is a prognostic factor in hepatocellular carcinoma treated with transarterial radioembolization: A retrospective cohort study

doi:10.4251/wjgo.120863

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 9

This Article

(0)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Oncology

ISSN

1948-5204

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article (XML)

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Sep 15, 2026; 18(9): 120863
Published online Sep 15, 2026. doi: 10.4251/wjgo.120863

Albumin-bilirubin score is a prognostic factor in hepatocellular carcinoma treated with transarterial radioembolization: A retrospective cohort study

Álvaro Suárez-Toribio, Ignacio López-Bueno, Javier Ampuero-Herrojo, Manuel Cabanillas-Casafranca, Álvaro Giráldez-Gallego, José Manuel Sousa-Martín, Juan Luis Tirado-Hospital, Álvaro Iglesias-López, Verónica Nacarino-Mejías, María Teresa Ferrer-Ríos

Álvaro Suárez-Toribio, Ignacio López-Bueno, Javier Ampuero-Herrojo, Manuel Cabanillas-Casafranca, Álvaro Giráldez-Gallego, José Manuel Sousa-Martín, María Teresa Ferrer-Ríos, Department of Gastroenterology, Hospital Universitario Virgen del Rocio, Sevilla 41013, Andalusia, Spain

Juan Luis Tirado-Hospital, Department of Nuclear Medicine, Hospital Universitario Virgen del Rocio, Sevilla 41013, Andalusia, Spain

Álvaro Iglesias-López, Verónica Nacarino-Mejías, Department of Interventional Radiology, Hospital Universitario Virgen del Rocio, Sevilla 41013, Andalusia, Spain

Co-corresponding authors: Álvaro Suárez-Toribio and María Teresa Ferrer-Ríos.

Author contributions: Suárez-Toribio A and Ferrer-Ríos MT contributed to conceptualization, data curation, formal analysis, investigation, visualization, writing of the original draft, and they contributed equally to this manuscript and are co-corresponding authors; López-Bueno I, Cabanillas-Casafranca M, Giráldez-Gallego Á, Sousa-Martín JM, Tirado-Hospital JL, Iglesias-López Á and Nacarino V, and Ferrer Ríos MT contributed to resources; Ampuero-Herrojo J contributed to validation; Ampuero-Herrojo J and Ferrer-Ríos MT contributed to methodology and supervision; Ampuero-Herrojo J, Giráldez-Gallego Á, Tirado-Hospital JL, and Iglesias-López Á contributed to writing, review and editing of the manuscript; Ferrer-Ríos MT was responsible for project administration. All authors have read and approved the final version of the manuscript.

AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript. AI tools (specifically ChatGPT, OpenAI) were used solely as assistive technologies for language refinement and structural organization. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, interpret results, or draw scientific conclusions.

Institutional review board statement: The study protocol was approved by the Research Ethics Committee of the Virgen Macarena-Virgen del Rocío University Hospitals (Approval No. SICEIA-2025-002463).

Informed consent statement: Given the retrospective nature of part of the study and the use of anonymized data, the requirement for informed consent was waived. Written informed consent was obtained from patients prospectively included in the registry.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The datasets used and/or analyzed during the current study are not publicly available due to institutional policies but are available from the corresponding author on reasonable request. All data are anonymized, and the risk of identification is low.

Corresponding author: Álvaro Suárez-Toribio, Researcher, Department of Gastroenterology, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot, Sevilla 41013, Andalusia, Spain. alvarostoribio@gmail.com

Received: March 10, 2026
Revised: May 17, 2026
Accepted: June 15, 2026
Published online: September 15, 2026
Processing time: 168 Days and 23.7 Hours

Abstract

BACKGROUND

While selective internal radiation therapy (SIRT), also known as transarterial radioembolization, is an established treatment for hepatocellular carcinoma (HCC), prognostic stratification remains challenging.

AIM

To identify prognostic factors for survival in patients with HCC treated with SIRT.

METHODS

A retrospective, single-center study was conducted, which included 50 patients with HCC treated with SIRT between February 2016 and May 2024. Demographic, clinical, and tumor-related variables were analyzed, including liver function, tumor burden, treatment response, and adverse events. Kaplan-Meier analysis determined overall survival (OS) and progression-free survival, while Cox regression models assessed prognostic factors.

RESULTS

Median OS was 22 months, with significant differences according to liver function assessed by the albumin-bilirubin (ALBI) score. Patients with ALBI grade 1 had longer survival than those with grade 2 [25 months vs 10 months; hazard ratio (HR) = 2.67, 95% confidence interval (CI): 1.2-6.0; P = 0.017]. A complete radiological response was achieved in 26% of patients and a partial response in 42%. The median progression-free survival was 9 months, but it was significantly shorter for patients with satellite nodules compared to those without (3 vs 11; HR = 2.44, 95%CI: 1.13-5.26; P = 0.013). Multivariate analysis confirmed the ALBI score as an independent predictor of OS (HR = 2.42, 95%CI: 1.02-5.74; P = 0.045).

CONCLUSION

The ALBI score is a useful and objective prognostic tool in patients with HCC undergoing SIRT. Its use may improve patient selection and clinical decision-making.

Keywords: Hepatocellular carcinoma; Selective internal radiation therapy; Albumin-bilirubin score; Yttrium-90; Satellite nodules

Core Tip: Selective internal radiation therapy is an established treatment for hepatocellular carcinoma, but prognostic stratification remains challenging. In this real-world cohort, the albumin-bilirubin score emerged as a key factor associated with overall survival, compared with conventional clinical parameters. These findings confirm that albumin-bilirubin is a simple, objective tool for patient selection and risk stratification, which can improve treatment decisions for patients undergoing selective internal radiation therapy.