Prognostic role of the Child-Turcotte-Pugh classification and ALBI grade in patients without cirrhosis and hepatocellular carcinoma

Background & aims While the Child-Turcotte-Pugh (CTP) classification as well as the albumin-bilirubin (ALBI) grade represent important clinical tools for risk stratification in patients with cirrhosis and hepatocellular carcinoma (HCC), there is no data on the prognostic ability in patients without cirrhosis and HCC.Methods Cohort 1 included unresectable patients with HCC and BCLC stage A-C from the Medical University of Vienna and the Sorbonne University, Paris. Cohort 2 included patients with unresectable HCC treated with atezolizumab/bevacizumab or durvalumab/tremelimumab from two large international databases (AB-Real and DT-Real studies). We evaluated the prognostic value of the CTP classification/ALBI grade for overall survival (OS) by calculating Cox regression analyses as well as time-dependent AUROCs.Results Cohort 1 included 184 patients without cirrhosis (CTP-B: n=22/12.0%) and 1173 patients with cirrhosis (CTP-B: n=414/35.3%), and cohort 2 comprised 259 patients without cirrhosis (CTP B: n=19/7.3%) and 841 patients with cirrhosis (CTP-B: n=187/23.3%). CTP classification was independently associated with OS in cohorts 1 (aHR: 3.04 [95%CI: 1.70-5.45], pConclusion CTP classification and ALBI grade are associated with prognosis in patients without cirrhosis and HCC, and their prognostic power is comparable to that in patients with cirrhosis and HCC.