Clinical and prognostic utility of ALBI versus Child-Pugh score in a Mexican population with hepatocellular carcinoma.

517 Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide. The assessment of liver function is crucial in determining the prognosis of patients. Aim: To compare the utility of the ALBI and CHILD-PUGH scores in predicting the prognosis and treatment of patients with hepatocellular carcinoma at the National Cancer Institute, Mexico. Methods: Retrospective, observational study. Included patients diagnosed with HCC and treated at the National Cancer Institute 2008-2021. Statistical analysis included: X 2 and t-test, Kaplan Meier, Log Rank, and Cox Regression. Statistical significance was assessed when p was bilaterally <0.05. Results: A total of 315 patients diagnosed with HCC were included, mostly male (61%) with a median age of 67 years, mostly in the advanced stages of the disease (90%). Regarding liver functionality scores, of the patients who were scored in CHILD-PUGH-A5 (n=124), 53% were in ALBI G1, while 47% scored ALBI G2. Regarding the CHILD-PUGH-A6 group (n=92) only 71% of patients scored ALBI G2, and among CHILD-PUGH-B7 score (n=55) patients, only 13% scored in the ALBI G3 group (p<0.001). In survival analysis, CHILD-PUGH-A5 patients had a median OS of 40 months, while CHILD-PUGH-A6 patients showed a median OS of 11 months (p<0.001). Patients with a CHILD-PUGH-B7 score showed a median OS of 10 months compared to patients with a CHILD-PUGH-B8 score who showed a median OS of 4 months (p=0.93). Among ALBI score, G1 patients did not reach median OS, while the median OS of patients with G2 and G3 was 13 and 4 months respectively (p<0.001). At Univariate analysis, histology (HR:1.22; p=0.021), bilirubin (HR:1.12; p<0.001), albumin (HR:0.33; p<0.001), CHILD-PUGH (HR:1.27; p<0.001), ALBI (HR:2.91; p<0.001), ECOG (HR:1.82; p<0.001), surgery (HR:2.24; p=0.029) and systemic treatment (HR:2.57; p<0.001) showed statistical differences. While only albumin (HR: 0.45; p=0.027), ECOG (HR: 1.49; p=0.006), systemic treatment (HR: 1.78; p=0.026) and ALBI score (HR: 1.71; p=0.032) remained predictors of OS. Conclusions: The study demonstrates that ALBI score presents a better prognostic and liver function stratification than CHILD-PUGH score in Mexican population.