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Background: The majority of patients who develop hepatocellular carcinoma (HCC) present with intermediate stage disease and undergo treatment with trans-arterial chemoembolisation (TACE). Patient selection plays an important role in treating patients with TACE as pre-treatment liver dysfunction predicts post treatment complications and overall survival. The albumin-bilirubin (ALBI) grade is an emerging model for accurate and objective assessment of hepatic function in patients with cirrhosis and HCC. We therefore conducted a systematic review and meta-analysis of published studies evaluating ALBI grade in HCC to evaluate its clinical utility as a prognostic marker in patients undergoing TACE. Method(s): Two independent researchers searched multiple electronic databases including PubMed, Embase Ovid, Medline, and Cochrane Library up till February 2019 for publications and abstracts regarding the use of ALBI grade in HCC patients. All the studies were systematically screened utilising the PRISMA tool for data extraction and synthesis. The primary outcome for this analysis was overall survival (OS), measured in months with 95% Confidence interval, as determined by ALBI grade in patients undergoing TACE treatment for HCC. Where this data was not available in the printed manuscript or abstract the corresponding author of each study was contacted for the additional data. Result(s): ALBI score was applied in a total of 6851 patients with HCC who underwent TACE treatment in the 8 studies that were included after screening 308 articles. Random effects model was used to analyse the aggregated data, and the Eggers test was not significant for publication bias forthe studies included for analysis in each ALBI grade. ALBI grade was able to stratify patients with distinct overall survival with 35.1 months, (95% CI[27.70-42.47], P<0.001) in ALBI grade 1, compared to 20.2 months (95% CI[17.12-23.3], P<0.001) in ALBI grade 2, and 12.01 months (95% Cl[8.71-15.31], P<0.001) in ALBI gr

Background: The majority of patients who develop hepatocellular carcinoma (HCC) present with intermediate stage disease and undergo treatment with trans-arterial chemoembolisation (TACE). Patient selection plays an important role in treating patients with TACE as pre-treatment liver dysfunction predicts post treatment complications and overall survival. The albumin-bilirubin (ALBI) grade is an emerging model for accurate and objective assessment of hepatic function in patients with cirrhosis and HCC. We therefore conducted a systematic review and meta-analysis of published studies evaluating ALBI grade in HCC to evaluate its clinical utility as a prognostic marker in patients undergoing TACE. Method(s): Two independent researchers searched multiple electronic databases including PubMed, Embase Ovid, Medline, and Cochrane Library up till February 2019 for publications and abstracts regarding the use of ALBI grade in HCC patients. All the studies were systematically screened utilising the PRISMA tool for data extraction and synthesis. The primary outcome for this analysis was overall survival (OS), measured in months with 95% Confidence interval, as determined by ALBI grade in patients undergoing TACE treatment for HCC. Where this data was not available in the printed manuscript or abstract the corresponding author of each study was contacted for the additional data. Result(s): ALBI score was applied in a total of 6851 patients with HCC who underwent TACE treatment in the 8 studies that were included after screening 308 articles. Random effects model was used to analyse the aggregated data, and the Eggers test was not significant for publication bias forthe studies included for analysis in each ALBI grade. ALBI grade was able to stratify patients with distinct overall survival with 35.1 months, (95% CI[27.70-42.47], P<0.001) in ALBI grade 1, compared to 20.2 months (95% CI[17.12-23.3], P<0.001) in ALBI grade 2, and 12.01 months (95% Cl[8.71-15.31], P<0.001) in ALBI gr