Evaluation of the ALBI, MELD, MELD-Na, MELD 3.0 score in patients with hepatocellular carcinoma treated with Yttrium-90 (90y)

Introduction and Objectives

Hepatocellular carcinoma (HCC) occupies the third cause of mortality worldwide. 10% of patients receive curative therapy. There are loco-regional therapies to improve patient survival such as (TACE) and radioembolization with Yttrium-90. There are prognostic scales, such as ALBI, MELD, MELD-Na, MELD 3.0, to identify those who will respond better to treatment.

To evaluate the potential of the ALBI, MELD, MELD-Na, MELD 3.0 index as a predictor of mortality in patients who received treatment with Yttrium-90

Materials and Patients

Patients with cirrhosis and HCC who were candidates for radiation embolization with Yttrium-90 were evaluated. The following scores ALBI, MELD, MELD-Na, MELD 3.0 were assessed before and after therapy.

Results

There were 7 patients, age 70±11.3 years, 60% women, all BCLC B and Child Pugh B, etiology of CH was 3 patients due to alcohol-associated liver disease, 2 patients due to MASLD and 2 cryptogenic, 4 patients had 2 sessions and 3 patients 1 session, complete response in 3 patients and 5 progressed. 3 patients died. The variables of leukocytes, hemoglobin, platelets, PT, INR, BT, AST, ALT, albumin, ALBI, MELD, MELD 3.0, MELD-Na, Child Pugh were compared without obtaining statistical significance (Table 1). The survival of the patients was 14.6 months. There were no complications or adverse effects with the Yttrium-90 treatment.

Conclusions

ALBI, MELD, MELD 3.0, MELD-Na score do not predict mortality in patients treated with Yttrium-90. A study with a larger number of patients is needed to correlate and obtain more significant results

Ethical statement

The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.

Declaration of interests

None

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Table 1. Blood cytometry, Liver Functional Tests & cancer scales systems in patients with cancer and treatment transarterial radioembolization (TARE) with Yttrium-90.

*** Outside clinical reference value // Paired Samples t Test (pre-post) *P<0.05 // AST- Aspartate transaminase, ALT- Alanine transaminase, ALP- Alkaline phosphatase, GGT- Gamma-glutamyltransferase, INR- International Normalized Ratio, PT-Prothrombin time // *BCL PRE A=1, B=6 y POST BCL A=1, B=4 y C=2//